Active NPI
Kenneth L. Odinet, Jr., D.D.S., M.D., Apmc
- Plastic Surgery Physician
- Lafayette, LA
National Provider Identifier
1881972735
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Plastic Surgery Physician
- License
- 019937
- Legal business name
- KENNETH L. ODINET, JR., D.D.S., M.D., APMC
- Practice address
- 200 Beaullieu Dr
BLDG. 6
Lafayette, LA 70508-7230 - Phone
- (337) 234-8648
- Fax
- (337) 233-0244
- NPI assigned
- Jul 26, 2011
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Kenneth L Odinet Jr., D.D.S,, M.D.
- Title
- Owner
- Phone
- (337) 234-8648
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Otolaryngology Physician | 207Y00000X | 019937 | LA | |
| Plastic Surgery Physician | 208200000X | 019937 | Primary |
Addresses
Primary practice location
200 Beaullieu Dr
BLDG. 6
Lafayette, LA 70508-7230
Mailing address
200 Beaullieu Dr
BLDG. 6
Lafayette, LA 70508-7230
Phone (337) 234-8648
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1388050 | Medicaid | LA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in LA
Enrollment records 1
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1311638400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1311638400000",
"number": "1881972735",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 BEAULLIEU DR",
"address_2": "BLDG. 6",
"city": "LAFAYETTE",
"state": "LA",
"postal_code": "705087230",
"telephone_number": "337-234-8648",
"fax_number": "337-233-0244"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 BEAULLIEU DR",
"address_2": "BLDG. 6",
"city": "LAFAYETTE",
"state": "LA",
"postal_code": "705087230",
"telephone_number": "337-234-8648",
"fax_number": "337-233-0244"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "KENNETH L. ODINET, JR., D.D.S., M.D., APMC",
"organizational_subpart": "NO",
"enumeration_date": "2011-07-26",
"last_updated": "2011-07-26",
"status": "A",
"authorized_official_last_name": "ODINET",
"authorized_official_first_name": "KENNETH",
"authorized_official_middle_name": "L",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "337-234-8648",
"authorized_official_name_suffix": "Jr.",
"authorized_official_credential": "D.D.S,, M.D."
},
"taxonomies": [
{
"code": "207Y00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Otolaryngology",
"state": "LA",
"license": "019937",
"primary": false
},
{
"code": "208200000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Plastic Surgery",
"state": null,
"license": "019937",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1388050",
"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 26, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.