Nela Dental of Farmerville, LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

NELA DENTAL OF FARMERVILLE, LLC

Practice address

7699 Highway 2
Farmerville, LA 71241-6165

Phone

(318) 368-9518

Fax

(318) 368-4480

NPI assigned

Feb 29, 2012

Organization subpart

No

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

Authorized official

Name

Carla Dawn Costello

Title

Business Manager

Phone

(318) 737-0965

Specialties & licenses 2

Addresses

Other identifiers 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Robert Vance Costello, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Lafayette, LA
  • NPI 1376565580

  General Practice

  NPD
• William Daniel Raymond, DDS

  • Dentist
  • Monroe, LA
  • NPI 1245465392
  NPD (past)

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

{
    "created_epoch": "1330473600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1676937600000",
    "number": "1881968402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7699 HIGHWAY 2",
            "city": "FARMERVILLE",
            "state": "LA",
            "postal_code": "712416165",
            "telephone_number": "318-368-9518",
            "fax_number": "318-368-4480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7699 HIGHWAY 2",
            "city": "FARMERVILLE",
            "state": "LA",
            "postal_code": "712416165",
            "telephone_number": "318-368-9518",
            "fax_number": "318-368-4480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NELA DENTAL OF FARMERVILLE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-29",
        "last_updated": "2023-02-21",
        "certification_date": "2023-02-21",
        "status": "A",
        "authorized_official_last_name": "COSTELLO",
        "authorized_official_first_name": "CARLA",
        "authorized_official_middle_name": "DAWN",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "318-737-0965"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "LA",
            "license": "5630",
            "primary": false
        },
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "26171",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Latessa Morris
• Garrett Myers
• Cassandra Gail Neal
• Deanna Jane Neal, FNPC
• Melissa Deshaun Neal, RSW
• Northeast Louisiana Rehabilitation
• Northside Pharmacy
• Frances Daniell Ogden, CIT-5973
• Gwendolyn Pabon
• Angela Patterson

• Dental Clinic/Center in Farmerville, LA
• Providers in Farmerville, LA by specialty
• Dental Clinic/Center in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 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.