Robert Burton Bode, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

3375 Issued in LA

Practice address

1144 Coolidge Blvd Ste a
Lafayette, LA 70503-2622

Phone

(337) 234-8788

Fax

(337) 234-8723

NPI assigned

Jul 10, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Vintage L Delahoussaye DDS Apdc

  • Dental Clinic/Center
  • Lafayette, LA
  • NPI 1407364730
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1801820790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1144 COOLIDGE BLVD STE A",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705032622",
            "telephone_number": "337-234-8788",
            "fax_number": "337-234-8723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1144 COOLIDGE BLVD STE A",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705032622",
            "telephone_number": "337-234-8788",
            "fax_number": "337-234-8723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BODE",
        "first_name": "ROBERT",
        "middle_name": "BURTON",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-10",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "LA",
            "license": "3375",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1833754",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bob Winston MD PSC
• Veronica Lynn Bobb
• Bochm-Cabanas Chiropractic Center
• Alejandro Antonio Bochm-Cabanas, DC
• Hillary Ackel Bodden, FNP-C
• Amie S Bodin, PHARM D
• Theresa Frederick Bodker, APRN
• Body in Motion Chiropractic and Rehab, LLC
• Sarah Boenig, AGACNP-BC
• Lydia Boggess

• General Practice Dentistry in Lafayette, LA
• Providers in Lafayette, LA by specialty
• General Practice Dentistry in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.