Active NPI
Scott Laval Taylor, D.D.S.
- General Practice Dentistry
- Shreveport, LA
National Provider Identifier
1831286509
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 2559
- Practice address
- 2550 Bert Kouns Industrial Loop
Shreveport, LA 71118 - Phone
- (318) 686-0866
- Fax
- (318) 686-8468
- NPI assigned
- Oct 6, 2006
- 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 | 2559 | LA | Primary |
Addresses
Primary practice location
2550 Bert Kouns Industrial Loop
Shreveport, LA 71118
Mailing address
2550 Bert Kouns Industrial Loop
Shreveport, LA 71118
Phone (318) 686-0866
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| D1120 | Other | LA | BLUE CROSS BLUE SHIELD |
| 28093 | Other | LA | UNITED CONCORDIA |
| 1825590 | Medicaid | LA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in LA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150921000102 | LA | Order and Referring Only - Dentist | 7113234337 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2559 | LA | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160092800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1831286509",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2550 BERT KOUNS INDUSTRIAL LOOP",
"city": "SHREVEPORT",
"state": "LA",
"postal_code": "71118",
"telephone_number": "318-686-0866",
"fax_number": "318-686-8468"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2550 BERT KOUNS INDUSTRIAL LOOP",
"city": "SHREVEPORT",
"state": "LA",
"postal_code": "71118",
"telephone_number": "318-686-0866",
"fax_number": "318-686-8468"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TAYLOR",
"first_name": "SCOTT",
"middle_name": "LAVAL",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-06",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "LA",
"license": "2559",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "D1120",
"state": "LA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED CONCORDIA",
"identifier": "28093",
"state": "LA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1825590",
"state": "LA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Shreveport, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.