Active NPI
Shane Michael Brien, D.D.S.
- General Practice Dentistry
- Hammond, LA
National Provider Identifier
1619107455
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 5998
- Practice address
- 800 C M Fagan Dr
Suite a
Hammond, LA 70403-6062 - Phone
- (504) 495-8035
- NPI assigned
- Jul 14, 2009
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 5998 | LA | Primary |
Addresses
Primary practice location
800 C M Fagan Dr
Suite a
Hammond, LA 70403-6062
Mailing address
1858 Ingleside Dr
Baton Rouge, LA 70808-1269
Phone (504) 495-8056
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 |
|---|---|---|---|
| 5998 | LA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1247529600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1247529600000",
"number": "1619107455",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1858 INGLESIDE DR",
"city": "BATON ROUGE",
"state": "LA",
"postal_code": "708081269",
"telephone_number": "504-495-8056"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "800 C M FAGAN DR",
"address_2": "SUITE A",
"city": "HAMMOND",
"state": "LA",
"postal_code": "704036062",
"telephone_number": "504-495-8035"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRIEN",
"first_name": "SHANE",
"middle_name": "MICHAEL",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-07-14",
"last_updated": "2009-07-14",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "LA",
"license": "5998",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hammond, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.