Individual provider Active NPI

Galen L Norgard, D.D.S.

  • General Practice Dentistry
  • Shreveport, LA
National Provider Identifier
1649398157
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
4095 Issued in LA
Practice address
8948 Kingston Rd
Shreveport, LA 71118-2730
Phone
(318) 687-3040
NPI assigned
Mar 26, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 4095 LA Primary

Addresses

Primary practice location

8948 Kingston Rd
Shreveport, LA 71118-2730

Mailing address

1203 Capilano Dr
Shreveport, LA 71106-8286
Phone (318) 798-6306

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
I20231206002286 LA Order and Referring Only - DentistPractitioner - Dentist 6002115128

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1649398157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1203 CAPILANO DR",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711068286",
            "telephone_number": "318-798-6306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8948 KINGSTON RD",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711182730",
            "telephone_number": "318-687-3040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NORGARD",
        "first_name": "GALEN",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "LA",
            "license": "4095",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shreveport, LA

Sources for this page

Verify at the official NPI Registry.