NPIMap

Organization Active NPI

Jeff Ellard DDS Apdc

  • Pediatric Dentistry
  • Baton Rouge, LA
National Provider Identifier
1649898982
Registry record updated Jul 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
Legal business name
JEFF ELLARD DDS APDC
Practice address
541 Shadows LN Ste B
Baton Rouge, LA 70806-6559
Phone
(225) 924-2010
Fax
(225) 926-5872
NPI assigned
Jul 13, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2020

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

Authorized official

Name
Dr. Jeff Ellard Ellard, DDS
Title
Owner President
Phone
(225) 924-2010

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X Primary

Addresses

Primary practice location

541 Shadows LN Ste B
Baton Rouge, LA 70806-6559

Mailing address

541 Shadows LN Ste B
Baton Rouge, LA 70806-6559
Phone (225) 924-2010

Other practice location 1

4155 Hwy 1 S Ste B
Port Allen, LA 70767-5822
Phone (225) 924-2010

Other identifiers 1

IdentifierTypeStateIssuer
1376547364MedicaidLA

National Provider Directory

National Provider Directory

Locations

541 Shadows Ln
Ste B
Baton Rouge, LA 70806
Phone (225) 573-2777

4155 Hwy 1 S
Ste B
Port Allen, LA 70767
Phone (225) 924-2010

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1594598400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1594598400000",
    "number": "1649898982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "541 SHADOWS LN STE B",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708066559",
            "telephone_number": "225-924-2010",
            "fax_number": "225-926-5872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "541 SHADOWS LN STE B",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708066559",
            "telephone_number": "225-924-2010",
            "fax_number": "225-926-5872"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4155 Hwy 1 S Ste B",
            "address_purpose": "LOCATION",
            "city": "Port Allen",
            "state": "LA",
            "postal_code": "707675822",
            "country_code": "US",
            "telephone_number": "225-924-2010",
            "fax_number": "225-926-5872",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "JEFF ELLARD DDS APDC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-13",
        "last_updated": "2020-07-13",
        "certification_date": "2020-07-13",
        "status": "A",
        "authorized_official_last_name": "ELLARD",
        "authorized_official_first_name": "JEFF",
        "authorized_official_middle_name": "ELLARD",
        "authorized_official_title_or_position": "OWNER PRESIDENT",
        "authorized_official_telephone_number": "225-924-2010",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1376547364",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baton Rouge, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2020; 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.