Individual provider Active NPI

John Kenneth Legleu Jr., D.D.S.

  • Periodontics
  • Baton Rouge, LA
National Provider Identifier
1871706812
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
2730 Issued in LA
Practice address
12071 Bricksome Dr
Baton Rouge, LA 70816
Phone
(225) 292-8121
NPI assigned
May 7, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X 2730 LA Primary

Addresses

Primary practice location

12071 Bricksome Dr
Baton Rouge, LA 70816

Mailing address

12071 Bricksome Dr
Baton Rouge, LA 70816
Phone (225) 292-8121

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151214000536 LA Order and Referring Only - DentistPractitioner - Dentist 3779884994

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2730LAMDPeriodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Arghami Periodontics and Implants Periodontics Past Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1178496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1871706812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12071 BRICKSOME DR",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "70816",
            "telephone_number": "225-292-8121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12071 BRICKSOME DR",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "70816",
            "telephone_number": "225-292-8121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEGLEU",
        "first_name": "JOHN",
        "middle_name": "KENNETH",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "LA",
            "license": "2730",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baton Rouge, LA

Sources for this page

Verify at the official NPI Registry.