Phil M Corder, D.D.S.

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

2397 Issued in LA

Practice address

117 Professional Dr
West Monroe, LA 71291-5331

Phone

(318) 387-8504

Fax

(318) 387-4757

NPI assigned

Feb 21, 2007

Last updated

Jul 8, 2007By the provider in NPPES

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

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1871638130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2204 POINT DR",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712012870",
            "telephone_number": "318-387-6905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 PROFESSIONAL DR",
            "city": "WEST MONROE",
            "state": "LA",
            "postal_code": "712915331",
            "telephone_number": "318-387-8504",
            "fax_number": "318-387-4757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORDER",
        "first_name": "PHIL",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "LA",
            "license": "2397",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1823970",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Clayton Collins Coon, M.D.
• Amber Coons, PT, DPT
• Lonnie Cooper I
• Monica Denise Coplin, N.P.
• Corbin J. Turpin, III, DDS, LLC
• Core Wellness Physical Therapy
• Lyla Corkern, M.A., LPC
• Dana Ayers Cormier, PHARMACIST
• Cornerstone Healthcare Group Holding Inc
• Cornerstone Hospital of West Monroe

• Pediatric Dentistry in West Monroe, LA
• Providers in West Monroe, LA by specialty
• Pediatric Dentistry in Louisiana

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.