Individual provider Active NPI

Harold Mark Borel, DDS

  • Dentist
  • Lafayette, LA
National Provider Identifier
1891982419
Registry record updated May 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
5867 Issued in LA
Practice address
1004 Surrey St
Lafayette, LA 70501-6143
Phone
(337) 456-6768
NPI assigned
Sep 27, 2007
Last updated
May 26, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 26, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 5867 LA Primary

Addresses

Primary practice location

1004 Surrey St
Lafayette, LA 70501-6143

Mailing address

806 Jefferson Ter
New Iberia, LA 70560-5727
Phone (337) 365-4945

Other practice location 1

317 Dernier St
Saint Martinville, LA 70582-3809
Phone (337) 342-2566

Other practice location 2

806 Jefferson Ter
New Iberia, LA 70560-5727
Phone (337) 365-4945

Other practice location 3

1009 Charity St
Abbeville, LA 70510-5302
Phone (337) 893-3443

Other identifiers 1

IdentifierTypeStateIssuer
1858676MedicaidLA

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
I20160219001747 LA Order and Referring Only - DentistPractitioner - Dentist 2961707526

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5867LAMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1190851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685059200000",
    "number": "1891982419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "806 JEFFERSON TER",
            "city": "NEW IBERIA",
            "state": "LA",
            "postal_code": "705605727",
            "telephone_number": "337-365-4945",
            "fax_number": "337-367-3917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1004 SURREY ST",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705016143",
            "telephone_number": "337-456-6768"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "317 Dernier St",
            "address_purpose": "LOCATION",
            "city": "Saint Martinville",
            "state": "LA",
            "postal_code": "705823809",
            "country_code": "US",
            "telephone_number": "337-342-2566",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "806 Jefferson Ter",
            "address_purpose": "LOCATION",
            "city": "New Iberia",
            "state": "LA",
            "postal_code": "705605727",
            "country_code": "US",
            "telephone_number": "337-365-4945",
            "fax_number": "337-367-3917",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1009 Charity St",
            "address_purpose": "LOCATION",
            "city": "Abbeville",
            "state": "LA",
            "postal_code": "705105302",
            "country_code": "US",
            "telephone_number": "337-893-3443",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOREL",
        "first_name": "HAROLD",
        "middle_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-27",
        "last_updated": "2023-05-26",
        "certification_date": "2023-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "LA",
            "license": "5867",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1858676",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, LA

Sources for this page

Verify at the official NPI Registry.