Individual provider Active NPI

David Elliott Doerle, D.D.S.

  • Dentist
  • New Iberia, LA
National Provider Identifier
1750620662
Registry record updated Feb 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2278 Issued in LA
Practice address
107 Arbor LN
New Iberia, LA 70563-2822
Phone
(337) 365-7434
NPI assigned
Feb 13, 2013
Last updated
Feb 13, 2013By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 13, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2278 LA Primary

Addresses

Primary practice location

107 Arbor LN
New Iberia, LA 70563-2822

Mailing address

107 Arbor LN
New Iberia, LA 70563-2822
Phone (337) 365-7434

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
I20150709002407 LA Order and Referring Only - DentistPractitioner - Dentist 8527370154

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1360713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1360713600000",
    "number": "1750620662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 ARBOR LN",
            "city": "NEW IBERIA",
            "state": "LA",
            "postal_code": "705632822",
            "telephone_number": "337-365-7434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 ARBOR LN",
            "city": "NEW IBERIA",
            "state": "LA",
            "postal_code": "705632822",
            "telephone_number": "337-365-7434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOERLE",
        "first_name": "DAVID",
        "middle_name": "ELLIOTT",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-02-13",
        "last_updated": "2013-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "LA",
            "license": "2278",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Iberia, LA

Sources for this page

Verify at the official NPI Registry.