Individual provider Active NPI

George Billeaud, D.D.S.

  • General Practice Dentistry
  • Lafayette, LA
National Provider Identifier
1720192503
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2344 Issued in LA
Practice address
1105 S College Rd Ste C
Lafayette, LA 70503-3067
Phone
(337) 232-8310
Fax
(337) 232-2221
NPI assigned
Aug 18, 2006
Sex
Male
Sole proprietor
Yes

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 2344 LA Primary

Addresses

Primary practice location

1105 S College Rd Ste C
Lafayette, LA 70503-3067

Mailing address

1105 S College Rd Ste C
Lafayette, LA 70503-3067
Phone (337) 232-8310

Other identifiers 2

IdentifierTypeStateIssuer
116687395150OtherLAHUMANA PROVIDER #
470033OtherLAUNITED CONCORDIA PROVIDER

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
I20160307002167 LA Order and Referring Only - DentistPractitioner - Dentist 0749586485

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2344LAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1720192503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1105 S COLLEGE RD STE C",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705033067",
            "telephone_number": "337-232-8310",
            "fax_number": "337-232-2221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1105 S COLLEGE RD STE C",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705033067",
            "telephone_number": "337-232-8310",
            "fax_number": "337-232-2221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BILLEAUD",
        "first_name": "GEORGE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "LA",
            "license": "2344",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA PROVIDER #",
            "identifier": "116687395150",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA PROVIDER",
            "identifier": "470033",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, LA

Sources for this page

Verify at the official NPI Registry.