Active NPI
Dustin Mitchell Kidder, D.D.S.
- General Practice Dentistry
- Baton Rouge, LA
National Provider Identifier
1801112073
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 5901
- Practice address
- 6535 Perkins Rd
Baton Rouge, LA 70808-4259 - Phone
- (225) 761-8585
- Fax
- (225) 761-1979
- NPI assigned
- Apr 13, 2010
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 5901 | LA | Primary |
Addresses
Primary practice location
6535 Perkins Rd
Baton Rouge, LA 70808-4259
Mailing address
6535 Perkins Rd
Baton Rouge, LA 70808-4259
Phone (225) 761-8585
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 |
|---|---|---|---|
| 5901 | LA | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1271116800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1271116800000",
"number": "1801112073",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6535 PERKINS RD",
"city": "BATON ROUGE",
"state": "LA",
"postal_code": "708084259",
"telephone_number": "225-761-8585",
"fax_number": "225-761-1979"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6535 PERKINS RD",
"city": "BATON ROUGE",
"state": "LA",
"postal_code": "708084259",
"telephone_number": "225-761-8585",
"fax_number": "225-761-1979"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIDDER",
"first_name": "DUSTIN",
"middle_name": "MITCHELL",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-04-13",
"last_updated": "2010-04-13",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "LA",
"license": "5901",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Baton Rouge, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.