Dillingham Optical Dispensary, Inc

Primary specialty

OpticianTaxonomy code 156FX1800X

Legal business name

DILLINGHAM OPTICAL DISPENSARY, INC

Practice address

1812 Roselawn Ave
Monroe, LA 71201-5434

Phone

(318) 387-1602

Fax

(318) 325-9425

NPI assigned

Jan 9, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Ben Dillingham

Title

Owner

Phone

(318) 255-0817

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1332288000000",
    "number": "1720137953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1812 ROSELAWN AVE",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712015434",
            "telephone_number": "318-387-1602",
            "fax_number": "318-325-9425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1812 ROSELAWN AVE",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712015434",
            "telephone_number": "318-387-1602",
            "fax_number": "318-325-9425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DILLINGHAM OPTICAL DISPENSARY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-09",
        "last_updated": "2012-03-21",
        "status": "A",
        "authorized_official_last_name": "DILLINGHAM",
        "authorized_official_first_name": "BEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "318-255-0817",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Technician/Technologist, Optician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1005509",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Optician in Monroe, LA
• Providers in Monroe, LA by specialty
• Optician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2012; 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.