Active NPI
Brett David Madere, DDS
- Dentist
- Reserve, LA
National Provider Identifier
1801233242
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 4435
- Practice address
- 190 Central Ave
P.O. Drawer O
Reserve, LA 70084-6000 - Phone
- (985) 536-3193
- NPI assigned
- May 24, 2013
- Last updated
- May 24, 2013
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 4435 | LA | Primary |
Addresses
Primary practice location
190 Central Ave
P.O. Drawer O
Reserve, LA 70084-6000
Mailing address
190 Central Ave
P.O. Drawer O
Reserve, LA 70084
Phone (985) 536-3193
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235264367 | Other | LA | CORPORATE NPI |
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 |
|---|---|---|---|
| 4435 | LA | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Brett D Madere DDS Apc | Dentist | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Dentist
- Reserve, LA
- NPI 1235264367
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1369353600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1369353600000",
"number": "1801233242",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "190 CENTRAL AVE",
"address_2": "P.O. DRAWER O",
"city": "RESERVE",
"state": "LA",
"postal_code": "70084",
"telephone_number": "985-536-3193"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "190 CENTRAL AVE",
"address_2": "P.O. DRAWER O",
"city": "RESERVE",
"state": "LA",
"postal_code": "700846000",
"telephone_number": "985-536-3193"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MADERE",
"first_name": "BRETT",
"middle_name": "DAVID",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-05-24",
"last_updated": "2013-05-24",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "LA",
"license": "4435",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CORPORATE NPI",
"identifier": "1235264367",
"state": "LA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Reserve, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.