NPIMap

Organization Active NPI

DLS of Alexandria

Doing business as John C Moreau Jr DDS

  • General Practice Dentistry
  • Alexandria, LA
National Provider Identifier
1730549700
Registry record updated Mar 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
3992 Issued in LA
Legal business name
DLS OF ALEXANDRIA
Doing business as
John C Moreau Jr DDS
Practice address
3820 Masonic Dr
Alexandria, LA 71301-3628
Phone
(318) 442-9555
Fax
(318) 442-0475
NPI assigned
Mar 3, 2016
Last updated
Mar 3, 2016By the provider in NPPES
Organization subpart
Yes
Parent organization
DLS OF ALEXANDRIAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 3, 2016

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

Authorized official

Name
John C Moreau Jr., DDSNPI 1710095161
Title
Owner
Phone
(318) 442-9555

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 3992 LA Primary

Addresses

Primary practice location

3820 Masonic Dr
Alexandria, LA 71301-3628

Mailing address

3820 Masonic Dr
Alexandria, LA 71301-3628
Phone (318) 442-9555

Other identifiers 1

IdentifierTypeStateIssuer
1839922MedicaidLA

Other names 1

  • John C Moreau Jr DDS Doing business as

National Provider Directory

National Provider Directory
Part of
DLS of Alexandria

Locations

3820 Masonic Dr
Alexandria, LA 71301
Phone (318) 442-9555

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1456963200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1456963200000",
    "number": "1730549700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3820 MASONIC DR",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "713013628",
            "telephone_number": "318-442-9555",
            "fax_number": "318-442-0475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3820 MASONIC DR",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "713013628",
            "telephone_number": "318-442-9555",
            "fax_number": "318-442-0475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DLS OF ALEXANDRIA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DLS OF ALEXANDRIA",
        "enumeration_date": "2016-03-03",
        "last_updated": "2016-03-03",
        "status": "A",
        "authorized_official_last_name": "MOREAU",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "318-442-9555",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "LA",
            "license": "3992",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1839922",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "John C Moreau Jr DDS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Alexandria, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2016; 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.