Individual provider Active NPI

Ramon Taguiam Tancioco III, DMD

  • Endodontics
  • Alexandria, LA
National Provider Identifier
1851883763
Registry record updated Jan 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
7393 Issued in LA
Practice address
213 Ansley Blvd
Alexandria, LA 71303-3782
Phone
(318) 443-5013
NPI assigned
Jun 6, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 30, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN1857975 MA
Endodontics 1223E0200X DEN.00204361 CO
Endodontics 1223E0200X 7393 LA Primary

Addresses

Primary practice location

213 Ansley Blvd
Alexandria, LA 71303-3782

Mailing address

809 Briarwood Cir
Leesville, LA 71446-9095
Phone (510) 579-4387

Other practice location 1

9450 E Mississippi Ave Unit A
Denver, CO 80247-2427
Phone (720) 463-2766

Other practice location 2

1 Kneeland Street
Endodontics Dept
Boston, MA 02111
Phone (617) 636-6889

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
DEN.00204361COMDEndodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Victor J Caronna DDS LLC Endodontics CurrentSince Apr 21, 2024 Accepting new patients
Daniel G. Lester DDS, PLLC Endodontics CurrentSince Feb 8, 2023 Accepting new patients

Locations

213 Ansley Blvd
Alexandria, LA 71303
Phone (318) 443-5013

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1528243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675036800000",
    "number": "1851883763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "809 BRIARWOOD CIR",
            "city": "LEESVILLE",
            "state": "LA",
            "postal_code": "714469095",
            "telephone_number": "510-579-4387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "213 ANSLEY BLVD",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "713033782",
            "telephone_number": "318-443-5013"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9450 E Mississippi Ave Unit A",
            "address_purpose": "LOCATION",
            "city": "Denver",
            "state": "CO",
            "postal_code": "802472427",
            "country_code": "US",
            "telephone_number": "720-463-2766",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Kneeland Street",
            "address_2": "Endodontics Dept",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "02111",
            "country_code": "US",
            "telephone_number": "617-636-6889",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TANCIOCO",
        "first_name": "RAMON",
        "middle_name": "TAGUIAM",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-06-06",
        "last_updated": "2023-01-30",
        "certification_date": "2023-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "DN1857975",
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "CO",
            "license": "DEN.00204361",
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "LA",
            "license": "7393",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alexandria, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2023; 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.