Active NPI
Pornpavee Panichkul, D.D.S, M.S.
- Prosthodontics
- New Orleans, LA
National Provider Identifier
1891125928
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthodontics
- License
- S-765
- Practice address
- 1100 Florida Ave
Lsu School of Dentistry
New Orleans, LA 70119 - Phone
- (504) 941-8282
- Fax
- (504) 941-8170
- NPI assigned
- Nov 27, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Prosthodontics | 1223P0700X | S-765 | LA | Primary |
Addresses
Primary practice location
1100 Florida Ave
Lsu School of Dentistry
New Orleans, LA 70119
Mailing address
1100 Florida Ave
RM No. 3341
New Orleans, LA 70119
Phone (504) 941-8184
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| S-765 | LA | MD | Prosthodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1385510400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1385510400000",
"number": "1891125928",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1100 FLORIDA AVE",
"address_2": "RM NO. 3341",
"city": "NEW ORLEANS",
"state": "LA",
"postal_code": "70119",
"telephone_number": "504-941-8184",
"fax_number": "504-941-8170"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1100 FLORIDA AVE",
"address_2": "LSU SCHOOL OF DENTISTRY",
"city": "NEW ORLEANS",
"state": "LA",
"postal_code": "70119",
"telephone_number": "504-941-8282",
"fax_number": "504-941-8170"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PANICHKUL",
"first_name": "PORNPAVEE",
"name_prefix": "Ms.",
"credential": "D.D.S, M.S.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-11-27",
"last_updated": "2013-11-27",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0700X",
"taxonomy_group": "",
"desc": "Dentist, Prosthodontics",
"state": "LA",
"license": "S-765",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New Orleans, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.