Active NPI
Kelly Marie Meilleur, DDS
- Periodontics
- Slidell, LA
National Provider Identifier
1760521496
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- 4496
- Practice address
- 2334 Gause Blvd E
Slidell, LA 70461-4141 - Phone
- (985) 645-9555
- Fax
- (985) 645-9551
- NPI assigned
- Feb 6, 2007
- Last updated
- May 19, 2008
- 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 |
|---|---|---|---|---|
| Periodontics | 1223P0300X | 4496 | LA | Primary |
Addresses
Primary practice location
2334 Gause Blvd E
Slidell, LA 70461-4141
Mailing address
2334 Gause Blvd E
Slidell, LA 70461-4141
Phone (985) 645-9555
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 |
|---|---|---|---|
| 4496 | LA | MD | Reflexologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170720000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1211155200000",
"number": "1760521496",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2334 GAUSE BLVD E",
"city": "SLIDELL",
"state": "LA",
"postal_code": "704614141",
"telephone_number": "985-645-9555",
"fax_number": "985-645-9551"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2334 GAUSE BLVD E",
"city": "SLIDELL",
"state": "LA",
"postal_code": "704614141",
"telephone_number": "985-645-9555",
"fax_number": "985-645-9551"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MEILLEUR",
"first_name": "KELLY",
"middle_name": "MARIE",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-02-06",
"last_updated": "2008-05-19",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "LA",
"license": "4496",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Slidell, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.