Individual provider Active NPI

Sapna Mathur, DMD

  • General Practice Dentistry
  • Slidell, LA
National Provider Identifier
1629144704
Registry record updated Aug 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
5257 Issued in LA
Practice address
420 Town Center Pkwy
Slidell, LA 70458-8000
Phone
(985) 214-1540
NPI assigned
Nov 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN013250 GA
General Practice Dentistry 1223G0001X 24220 TX
General Practice Dentistry 1223G0001X 5257 LA Primary

Addresses

Primary practice location

420 Town Center Pkwy
Slidell, LA 70458-8000

Mailing address

1108 Joe Yenni Blvd Apt 136
Kenner, LA 70065-1295
Phone (404) 783-1389

Other identifiers 2

IdentifierTypeStateIssuer
197196201MedicaidTX
1629144704OtherLADMD

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
I20170731000090 LA Order and Referring Only - DentistPractitioner - Dentist 3678844305

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN013250GAMDGeneral Practice Dentistry
5257LAMDGeneral Practice Dentistry
24220TXMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Jacob Dent DDS Dentists of Slidell a Professional Corporation PastSince Aug 25, 2019 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": "1164672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566172800000",
    "number": "1629144704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1108 JOE YENNI BLVD APT 136",
            "city": "KENNER",
            "state": "LA",
            "postal_code": "700651295",
            "telephone_number": "404-783-1389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 TOWN CENTER PKWY",
            "city": "SLIDELL",
            "state": "LA",
            "postal_code": "704588000",
            "telephone_number": "985-214-1540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHUR",
        "first_name": "SAPNA",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-28",
        "last_updated": "2019-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN013250",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "24220",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "LA",
            "license": "5257",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "197196201",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMD",
            "identifier": "1629144704",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Slidell, LA

Sources for this page

Verify at the official NPI Registry.