William Alan Puckett Jr., D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

5978 Issued in LA

Practice address

1408 Peterman Dr
Alexandria, LA 71301-3432

Phone

(318) 427-9220

Fax

(318) 442-1811

NPI assigned

Jun 10, 2009

Last updated

Apr 3, 2013By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Red River Dental LLC

  • Dental Clinic/Center
  • Alexandria, LA
  • NPI 1154661064
  NPD (past) Authorized official
• Dental Sleep Medicine Associates, LLC

  • Dental Clinic/Center
  • Pineville, LA
  • NPI 1326604463
  NPD (past)

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

{
    "created_epoch": "1244592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364947200000",
    "number": "1639305170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1408 PETERMAN DR",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "713013432",
            "telephone_number": "318-427-9220",
            "fax_number": "318-442-1811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1408 PETERMAN DR",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "713013432",
            "telephone_number": "318-427-9220",
            "fax_number": "318-442-1811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUCKETT",
        "first_name": "WILLIAM",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-06-10",
        "last_updated": "2013-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "LA",
            "license": "5978",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1859788",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lindsey Elizabeth Pringle, LPC
• Anjelica Proby
• Professional Anesthesia Consultants, LLP
• Professional Pharmacy RX, LLC (Professional Pharmacy)
• Psychiatric Consultation Services, LLC
• Sharon Anne Pugh, PHD, MP
• Craig Pullen
• Quality Anesthesia Inc
• Quality Care Nursing
• Quality Health Services

• General Practice Dentistry in Alexandria, LA
• Providers in Alexandria, LA by specialty
• General Practice Dentistry in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.