Active NPI
David Carl Degenova, D.D.S.
- Orthodontics and Dentofacial Orthopedics Dentistry
- Metairie, LA
National Provider Identifier
1619096344
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- 3137
- Practice address
- 3333 Kingman St Ste 200
Metairie, LA 70006-4236 - Phone
- (504) 885-8863
- NPI assigned
- Mar 27, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 3137 | LA | Primary |
Addresses
Primary practice location
3333 Kingman St Ste 200
Metairie, LA 70006-4236
Mailing address
5529 Cherlyn Dr
New Orleans, LA 70124-1136
Phone (504) 615-8906
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 |
|---|---|---|---|
| 3137 | LA | MD | Orthodontics and Dentofacial Orthopedic Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174953600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1619096344",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5529 CHERLYN DR",
"city": "NEW ORLEANS",
"state": "LA",
"postal_code": "701241136",
"telephone_number": "504-615-8906",
"fax_number": "504-885-8864"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3333 KINGMAN ST STE 200",
"city": "METAIRIE",
"state": "LA",
"postal_code": "700064236",
"telephone_number": "504-885-8863"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEGENOVA",
"first_name": "DAVID",
"middle_name": "CARL",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-03-27",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "LA",
"license": "3137",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Metairie, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.