David Leroy Cook, DDS
Individual provider Active NPI Dentist · Chauvin, LA
NPI 1851595573 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1851595573
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 4058 (LA)
- Practice address
- 100 Johanna St
Chauvin, LA 70344 - Phone
- (985) 594-4217
- NPI assigned
- Jun 14, 2007
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4058 | LA | MD | Addiction (Substance Use Disorder) Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 4058 | LA | Yes |
Addresses
Primary practice location
100 Johanna St
Chauvin, LA 70344
Mailing address
PO Box 387
Chauvin, LA 70344
Phone (985) 594-4217
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1840581 | Medicaid | LA |
Other names
- Dr. David Leroy Cook
Other providers in Chauvin, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.