Individual provider Active NPI

Amber Shay Cook, DDS

  • General Practice Dentistry
  • New Orleans, LA
National Provider Identifier
1619469897
Registry record updated Jun 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
7512 Issued in LA
Practice address
3004 Gentilly Blvd
New Orleans, LA 70122-3808
Phone
(504) 435-1800
NPI assigned
Jun 4, 2018
Last updated
Jun 19, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN23344 FL
General Practice Dentistry 1223G0001X 7169 NV
General Practice Dentistry 1223G0001X 7512 LA Primary

Addresses

Primary practice location

3004 Gentilly Blvd
New Orleans, LA 70122-3808

Mailing address

3004 Gentilly Blvd
New Orleans, LA 70122-3808

Other practice location 1

2400 Veterans Memorial Blvd Ste 210
Kenner, LA 70062-8723
Phone (504) 833-3200

Other identifiers 1

IdentifierTypeStateIssuer
100074400MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20180911002432 FL Order and Referring Only - DentistPractitioner - Dentist 2365792439

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN23344FLMDDentist
7512LAMDGeneral Practice Dentistry
7169NVMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Regine Dyer DDS,LLC & Matthew Henson DDS, LLC General Practice PastSince Jan 17, 2021 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1528070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718755200000",
    "number": "1619469897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3004 GENTILLY BLVD",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701223808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3004 GENTILLY BLVD",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701223808",
            "telephone_number": "504-435-1800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2400 Veterans Memorial Blvd Ste 210",
            "address_purpose": "LOCATION",
            "city": "Kenner",
            "state": "LA",
            "postal_code": "700628723",
            "country_code": "US",
            "telephone_number": "504-833-3200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COOK",
        "first_name": "AMBER",
        "middle_name": "SHAY",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-04",
        "last_updated": "2024-06-19",
        "certification_date": "2024-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN23344",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NV",
            "license": "7169",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "LA",
            "license": "7512",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100074400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Orleans, LA

Sources for this page

Verify at the official NPI Registry.