Individual provider Active NPI

Leonard H McWilliams Jr., DDS

  • General Practice Dentistry
  • Deridder, LA
National Provider Identifier
1609988799
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
3362 Issued in LA
Practice address
501 Bon Ami St
Deridder, LA 70634-4925
Phone
(337) 462-1315
Fax
(337) 462-6411
NPI assigned
Aug 31, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 3362 LA Primary

Addresses

Primary practice location

501 Bon Ami St
Deridder, LA 70634-4925

Mailing address

501 Bon Ami St
Deridder, LA 70634-4925
Phone (337) 462-1315

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160415001204 LA Order and Referring Only - DentistPractitioner - Dentist 2567760093

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3362LAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Leonard H McWilliams DDS LLC General Practice Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1609988799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 BON AMI ST",
            "city": "DERIDDER",
            "state": "LA",
            "postal_code": "706344925",
            "telephone_number": "337-462-1315",
            "fax_number": "337-462-6411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 BON AMI ST",
            "city": "DERIDDER",
            "state": "LA",
            "postal_code": "706344925",
            "telephone_number": "337-462-1315",
            "fax_number": "337-462-6411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCWILLIAMS",
        "first_name": "LEONARD",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "LA",
            "license": "3362",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Deridder, LA

Sources for this page

Verify at the official NPI Registry.