Active NPI
Melanie Fowler, DDS
- Orthodontics and Dentofacial Orthopedics Dentistry
- Lafayette, LA
National Provider Identifier
1861421224
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- 5402
- Practice address
- 4906 Ambassador Caffery Pkwy
BLDG O
Lafayette, LA 70508-6916 - Phone
- (337) 981-4350
- Fax
- (337) 981-4352
- NPI assigned
- Jun 30, 2006
- Last updated
- Jul 10, 2007
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 5402 | LA | Primary |
Addresses
Primary practice location
4906 Ambassador Caffery Pkwy
BLDG O
Lafayette, LA 70508-6916
Mailing address
4906 Ambassador Caffery Pkwy
BLDG O
Lafayette, LA 70508-6916
Phone (337) 981-4350
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1854026 | Medicaid | LA | |
| 43851104030 | Other | LA | BLUE CROSS BLUS SHIELD |
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 |
|---|---|---|---|
| 5402 | LA | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151625600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1184025600000",
"number": "1861421224",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4906 AMBASSADOR CAFFERY PKWY",
"address_2": "BLDG O",
"city": "LAFAYETTE",
"state": "LA",
"postal_code": "705086916",
"telephone_number": "337-981-4350",
"fax_number": "337-981-4352"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4906 AMBASSADOR CAFFERY PKWY",
"address_2": "BLDG O",
"city": "LAFAYETTE",
"state": "LA",
"postal_code": "705086916",
"telephone_number": "337-981-4350",
"fax_number": "337-981-4352"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FOWLER",
"first_name": "MELANIE",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-30",
"last_updated": "2007-07-10",
"status": "A"
},
"taxonomies": [
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "LA",
"license": "5402",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1854026",
"state": "LA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUS SHIELD",
"identifier": "43851104030",
"state": "LA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Lafayette, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 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.