Active NPI
Jim Pichon, DDS, MD
- Dentist
- Bossier City, LA
National Provider Identifier
1639813702
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 40377
- Practice address
- 5922 Wildcrest St
Bossier City, LA 71111-5620 - Phone
- (903) 372-3340
- NPI assigned
- Apr 25, 2022
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 40377 | TX | Primary |
| Student in an Organized Health Care Education/Training Program | 390200000X |
Addresses
Primary practice location
5922 Wildcrest St
Bossier City, LA 71111-5620
Mailing address
5922 Wildcrest St
Bossier City, LA 71111-5620
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
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1650844800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1735862400000",
"number": "1639813702",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5922 WILDCREST ST",
"city": "BOSSIER CITY",
"state": "LA",
"postal_code": "711115620"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5922 WILDCREST ST",
"city": "BOSSIER CITY",
"state": "LA",
"postal_code": "711115620",
"telephone_number": "903-372-3340"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PICHON",
"first_name": "JIM",
"credential": "DDS, MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2022-04-25",
"last_updated": "2025-01-03",
"certification_date": "2025-01-03",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "TX",
"license": "40377",
"primary": true
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bossier City, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.