Individual provider Active NPI

Lynn R Leblanc, DDS

  • General Practice Dentistry
  • Lafayette, LA
National Provider Identifier
1699832386
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
0002459 Issued in LA
Practice address
1534 W Pinhook Rd
Lafayette, LA 70503-3159
Phone
(337) 235-4960
Fax
(337) 235-4426
NPI assigned
Jan 2, 2007
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 0002459 LA Primary

Addresses

Primary practice location

1534 W Pinhook Rd
Lafayette, LA 70503-3159

Mailing address

1534 W Pinhook Rd
Lafayette, LA 70503-3159
Phone (337) 235-4960

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
I20160921002200 LA Order and Referring Only - DentistPractitioner - Dentist 0547557316

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0002459LAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1167696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1699832386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1534 W PINHOOK RD",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705033159",
            "telephone_number": "337-235-4960",
            "fax_number": "337-235-4426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1534 W PINHOOK RD",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705033159",
            "telephone_number": "337-235-4960",
            "fax_number": "337-235-4426"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEBLANC",
        "first_name": "LYNN",
        "middle_name": "R",
        "name_prefix": "Mr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "LA",
            "license": "0002459",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, LA

Sources for this page

Verify at the official NPI Registry.