Active NPI
Carlito P. Ilawan, DDS
- Dentist
- Covington, LA
National Provider Identifier
1902073422
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 4361
- Practice address
- 400 Myrtle Dr
Covington, LA 70433-8149 - Phone
- (985) 892-2711
- Fax
- (985) 892-7669
- NPI assigned
- May 14, 2008
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Dentist | 122300000X | 4361 | LA | Primary |
Addresses
Primary practice location
400 Myrtle Dr
Covington, LA 70433-8149
Mailing address
400 Myrtle Dr
Covington, LA 70433-8149
Phone (985) 892-2711
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1843610 | Medicaid | LA | |
| 971021 | Other | PA | UNITED CONCORDIA |
| A2370 | Other | LA | BLUE CROSS BLUE SHIELD OF LA |
| 00660199 | Medicaid | MS |
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Carlito P Ilawan, DDS, Covington, Inc | Dentist | Current | Accepting new patients |
| Charlie P. Ilawan, DDS, Apdc | Past | Accepting new patients |
Locations
400 Myrtle Dr
Covington, LA 70433
Phone (985) 892-2711
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Dentist
- Covington, LA
- NPI 1750105953
-
- General Practice Dentistry
- Bogalusa, LA
- NPI 1578777108
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1210723200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757548800000",
"number": "1902073422",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "400 MYRTLE DR",
"city": "COVINGTON",
"state": "LA",
"postal_code": "704338149",
"telephone_number": "985-892-2711",
"fax_number": "985-892-7669"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "400 MYRTLE DR",
"city": "COVINGTON",
"state": "LA",
"postal_code": "704338149",
"telephone_number": "985-892-2711",
"fax_number": "985-892-7669"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ILAWAN",
"first_name": "CARLITO",
"middle_name": "P.",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-05-14",
"last_updated": "2025-09-11",
"certification_date": "2025-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "LA",
"license": "4361",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1843610",
"state": "LA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED CONCORDIA",
"identifier": "971021",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD OF LA",
"identifier": "A2370",
"state": "LA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00660199",
"state": "MS"
}
],
"endpoints": [],
"other_names": []
}Other providers in Covington, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.