NPIMap

Organization Active NPI

Christus Health Central Louisiana

Doing business as CHRISTUS Coushatta Dental Clinic

  • Dental Clinic/Center
  • Coushatta, LA
National Provider Identifier
1790767267
Registry record updated Oct 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
551RHC-1 Issued in LA
Legal business name
CHRISTUS HEALTH CENTRAL LOUISIANA
Doing business as
CHRISTUS Coushatta Dental Clinic
Practice address
1401 Industrial Dr
Coushatta, LA 71019
Phone
(318) 932-2100
Fax
(318) 932-2010
NPI assigned
Nov 18, 2005
Last updated
Oct 20, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2022

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

Authorized official

Name
Monte Wilson
Title
Ceo
Phone
(337) 470-2100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X 551RHC-1 LA Primary

Addresses

Primary practice location

1401 Industrial Dr
Coushatta, LA 71019

Mailing address

PO Box 847329
Dallas, TX 75284-7329
Phone (800) 756-7999

Other names 1

  • CHRISTUS Coushatta Dental Clinic Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Esteban a Martinez MD11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

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": "1132272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666224000000",
    "number": "1790767267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 847329",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752847329",
            "telephone_number": "800-756-7999",
            "fax_number": "469-282-1791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 INDUSTRIAL DR",
            "city": "COUSHATTA",
            "state": "LA",
            "postal_code": "71019",
            "telephone_number": "318-932-2100",
            "fax_number": "318-932-2010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHRISTUS HEALTH CENTRAL LOUISIANA",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-18",
        "last_updated": "2022-10-20",
        "certification_date": "2022-10-20",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "MONTE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "337-470-2100"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "LA",
            "license": "551RHC-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CHRISTUS Coushatta Dental Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "CHRISTUS Coushatta Dental Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Coushatta, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2022; 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.