NPIMap

Organization Active NPI

Spillover, LLC

  • Dentist
  • Gonzales, LA
National Provider Identifier
1780074054
Registry record updated Jan 26, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
SPILLOVER, LLC
Practice address
1116 S Purpera Ave
Gonzales, LA 70737-4361
Phone
(225) 647-3577
Fax
(225) 647-8762
NPI assigned
Jan 26, 2015
Last updated
Jan 26, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2015

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

Authorized official

Name
Dawn Best
Title
Office Manager
Phone
(225) 647-3577

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X Primary

Addresses

Primary practice location

1116 S Purpera Ave
Gonzales, LA 70737-4361

Mailing address

1116 S Purpera Ave
Gonzales, LA 70737-4361
Phone (225) 647-3577

National Provider Directory

National Provider Directory

Locations

1116 S Purpera Ave
Gonzales, LA 70737
Phone (225) 647-3577

Practitioners & affiliated clinicians

Practitioners 3

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": "1422230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1422230400000",
    "number": "1780074054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1116 S PURPERA AVE",
            "city": "GONZALES",
            "state": "LA",
            "postal_code": "707374361",
            "telephone_number": "225-647-3577",
            "fax_number": "225-647-8762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1116 S PURPERA AVE",
            "city": "GONZALES",
            "state": "LA",
            "postal_code": "707374361",
            "telephone_number": "225-647-3577",
            "fax_number": "225-647-8762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPILLOVER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-26",
        "last_updated": "2015-01-26",
        "status": "A",
        "authorized_official_last_name": "BEST",
        "authorized_official_first_name": "DAWN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "225-647-3577"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gonzales, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2015; 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.