Jan T Bagwell DDS

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

JAN T BAGWELL DDS

Practice address

189 Keystone Rd
Monroe, LA 71203-8936

Phone

(318) 665-4423

NPI assigned

Jan 10, 2019

Organization subpart

No

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

Authorized official

Name

Dr. Jan T Bagwell, DDS

Title

Owner

Phone

(318) 665-4423

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 3

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

• Brent Charles Alexander Jr., DDS

  • Dentist
  • Monroe, LA
  • NPI 1124868104
  NPD (past)
• Janette T Bagwell, DDS

  • General Practice Dentistry
  • Monroe, LA
  • NPI 1447357264
  NPD (past)
• Michael Wayne Walker, DDS

  • General Practice Dentistry
  • Monroe, LA
  • NPI 1790051522
  NPD (past)

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

{
    "created_epoch": "1547078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1547078400000",
    "number": "1669945861",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "189 KEYSTONE RD",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712038936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "189 KEYSTONE RD",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712038936",
            "telephone_number": "318-665-4423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAN T BAGWELL DDS",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-10",
        "last_updated": "2019-01-10",
        "status": "A",
        "authorized_official_last_name": "BAGWELL",
        "authorized_official_first_name": "JAN",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "318-665-4423",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NATIONAL PROVIDER NUMBER/ NPI",
            "identifier": "1760917561",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Keyandrea James
• Linda U. James, LCSW
• Melanie James
• Tarneesha James
• Jacinta Shanay Jamison
• Janice R. Pharr, MD, LLC
• Mary R. Jans, NP
• Lakesha Danielle January
• Ratonya January
• Jordan Leigh Jarrette, FNP

• Dental Clinic/Center in Monroe, LA
• Providers in Monroe, LA by specialty
• Dental Clinic/Center in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2019; 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.