Individual provider Active NPI

Scott Clayton Kogler

  • General Practice Dentistry
  • Gonzales, LA
National Provider Identifier
1659450765
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
3297 Issued in LA
Practice address
306 S Burnside Ave
Gonzales, LA 70737-3444
Phone
(225) 621-2703
Fax
(225) 644-0493
NPI assigned
Nov 2, 2006
Sex
Male
Sole proprietor
No

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 3297 LA Primary

Addresses

Primary practice location

306 S Burnside Ave
Gonzales, LA 70737-3444

Mailing address

306 S Burnside Ave
Gonzales, LA 70737-3444
Phone (225) 621-2703

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

State licenses

LicenseStateTypeSpecialty
3297LAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1162425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1659450765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "306 S BURNSIDE AVE",
            "city": "GONZALES",
            "state": "LA",
            "postal_code": "707373444",
            "telephone_number": "225-621-2703",
            "fax_number": "225-644-0493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "306 S BURNSIDE AVE",
            "city": "GONZALES",
            "state": "LA",
            "postal_code": "707373444",
            "telephone_number": "225-621-2703",
            "fax_number": "225-644-0493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOGLER",
        "first_name": "SCOTT",
        "middle_name": "CLAYTON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "LA",
            "license": "3297",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gonzales, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.