Active NPI
Morgan Mains Vanzandt, DDS
- General Practice Dentistry
- Shreveport, LA
National Provider Identifier
1710415849
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 6756
- Practice address
- 2120 Bert Koun Loop Ste a
Shreveport, LA 71118-3351 - Phone
- (318) 668-3350
- NPI assigned
- Jun 2, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 6756 | LA | Primary |
Addresses
Primary practice location
2120 Bert Koun Loop Ste a
Shreveport, LA 71118-3351
Mailing address
6240 Mourning Dove Dr
Baton Rouge, LA 70817-1108
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
| License | State | Type | Specialty |
|---|---|---|---|
| 6756 | LA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1496361600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1496361600000",
"number": "1710415849",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6240 MOURNING DOVE DR",
"city": "BATON ROUGE",
"state": "LA",
"postal_code": "708171108"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2120 BERT KOUN LOOP STE A",
"city": "SHREVEPORT",
"state": "LA",
"postal_code": "711183351",
"telephone_number": "318-668-3350"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VANZANDT",
"first_name": "MORGAN",
"middle_name": "MAINS",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-06-02",
"last_updated": "2017-06-02",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "LA",
"license": "6756",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Shreveport, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.