Active NPI
Lakesha Wilson, DENTAL HYGIENIST
- Dental Hygienist
- Bossier, LA
National Provider Identifier
1619034824
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- 3499
- Practice address
- 1067 Twinning Dr.
Bossier, LA 71110 - Phone
- (318) 456-4018
- NPI assigned
- Jan 3, 2007
- Last updated
- Sep 12, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | 3499 | LA | Primary |
| Dental Hygienist | 124Q00000X | 3499-08 | LA |
Addresses
Primary practice location
1067 Twinning Dr.
Bossier, LA 71110
Mailing address
1067 Twinning Dr.
Bossier, LA 71110
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3499 | LA | MD | Dental Hygienist |
| 3499-08 | LA | MD | Dental Hygienist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167782400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1221177600000",
"number": "1619034824",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1067 TWINNING DR.",
"city": "BOSSIER",
"state": "LA",
"postal_code": "71110"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1067 TWINNING DR.",
"city": "BOSSIER",
"state": "LA",
"postal_code": "71110",
"telephone_number": "318-456-4018"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "LAKESHA",
"credential": "DENTAL HYGIENIST",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-03",
"last_updated": "2008-09-12",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "LA",
"license": "3499",
"primary": true
},
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "LA",
"license": "3499-08",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bossier, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.