Individual provider Active NPI

Timothy Stewart Fontenot, D.D.S.

  • General Practice Dentistry
  • Eunice, LA
National Provider Identifier
1881852176
Registry record updated May 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
5879 Issued in LA
Practice address
149 N 3Rd St
Eunice, LA 70535-3307
Phone
(337) 457-1342
Fax
(337) 457-1354
NPI assigned
May 23, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 5879 LA Primary

Addresses

Primary practice location

149 N 3Rd St
Eunice, LA 70535-3307

Mailing address

149 N 3Rd St
Eunice, LA 70535-3307
Phone (337) 457-1342

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

LicenseStateTypeSpecialty
5879LAMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1211500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211500800000",
    "number": "1881852176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "149 N 3RD ST",
            "city": "EUNICE",
            "state": "LA",
            "postal_code": "705353307",
            "telephone_number": "337-457-1342",
            "fax_number": "337-457-1354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "149 N 3RD ST",
            "city": "EUNICE",
            "state": "LA",
            "postal_code": "705353307",
            "telephone_number": "337-457-1342",
            "fax_number": "337-457-1354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FONTENOT",
        "first_name": "TIMOTHY",
        "middle_name": "STEWART",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-23",
        "last_updated": "2008-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "LA",
            "license": "5879",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eunice, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2008; 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.