NPIMap

Organization Active NPI

Nela Dental of Monroe, LLC

Doing business as NELA Dental- Monroe

  • Dentist
  • Monroe, LA
National Provider Identifier
1659788057
Registry record updated Mar 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
NELA DENTAL OF MONROE, LLC
Doing business as
NELA Dental- Monroe
Practice address
2016 Tower Dr
Monroe, LA 71201-5036
Phone
(318) 387-5732
NPI assigned
Jul 17, 2014
Last updated
Mar 9, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2023

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

Authorized official

Name
Robert Vance Costello, D.D.S.
Title
Manager
Phone
(318) 737-0964

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X LA Primary

Addresses

Primary practice location

2016 Tower Dr
Monroe, LA 71201-5036

Mailing address

2016 Tower Dr
Monroe, LA 71201-5036
Phone (318) 387-5732

Other names 1

  • NELA Dental- Monroe Doing business as

National Provider Directory

National Provider Directory

Locations

1220 Stubbs Ave
Monroe, LA 71201
Phone (318) 387-3812

2016 Tower Dr
Monroe, LA 71201
Phone (318) 387-5432

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1405555200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678320000000",
    "number": "1659788057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2016 TOWER DR",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712015036",
            "telephone_number": "318-387-5732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2016 TOWER DR",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712015036",
            "telephone_number": "318-387-5732"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NELA DENTAL OF MONROE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-17",
        "last_updated": "2023-03-09",
        "certification_date": "2023-03-09",
        "status": "A",
        "authorized_official_last_name": "COSTELLO",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "VANCE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "318-737-0964",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "LA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NELA Dental- Monroe",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "NELA Dental- Monroe",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Monroe, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2023; 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.