Active NPI
Leslie J Jacobs, DDS
- Pediatric Dentistry
- Lafayette, LA
National Provider Identifier
1720115058
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 5189
- Practice address
- 113 Rue Fontaine
Lafayette, LA 70508 - Phone
- (337) 500-1500
- NPI assigned
- Feb 27, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 5189 | LA | Primary |
Addresses
Primary practice location
113 Rue Fontaine
Lafayette, LA 70508
Mailing address
113 Rue Fontaine
Lafayette, LA 70508
Phone (337) 500-1500
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 452452184 | Other | LA | DENTAL INSURANCES |
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 |
|---|---|---|---|
| 5189 | LA | MD | Pediatric Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172534400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1543190400000",
"number": "1720115058",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "113 RUE FONTAINE",
"city": "LAFAYETTE",
"state": "LA",
"postal_code": "70508",
"telephone_number": "337-500-1500"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "113 RUE FONTAINE",
"city": "LAFAYETTE",
"state": "LA",
"postal_code": "70508",
"telephone_number": "337-500-1500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACOBS",
"first_name": "LESLIE",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-02-27",
"last_updated": "2018-11-26",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "LA",
"license": "5189",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DENTAL INSURANCES",
"identifier": "452452184",
"state": "LA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lafayette, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.