Individual provider Active NPI

Brock Barras, DDS

  • General Practice Dentistry
  • Lafayette, LA
National Provider Identifier
1912109307
Registry record updated Apr 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
5622 Issued in LA
Practice address
1700 Kaliste Saloom Rd
BLDG 4
Lafayette, LA 70508-6186
Phone
(337) 235-3395
Fax
(337) 234-5789
NPI assigned
Jun 5, 2007
Last updated
Apr 13, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 5622 LA Primary

Addresses

Primary practice location

1700 Kaliste Saloom Rd
BLDG 4
Lafayette, LA 70508-6186

Mailing address

1700 Kaliste Saloom Rd
BLDG 4
Lafayette, LA 70508-6186
Phone (337) 235-3395

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
I20160513000988 LA Order and Referring Only - DentistPractitioner - Dentist 0749579704

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5622LAMDProfessional Counselor

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1181001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1460505600000",
    "number": "1912109307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 KALISTE SALOOM RD",
            "address_2": "BLDG 4",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705086186",
            "telephone_number": "337-235-3395",
            "fax_number": "337-234-5789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 KALISTE SALOOM RD",
            "address_2": "BLDG 4",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705086186",
            "telephone_number": "337-235-3395",
            "fax_number": "337-234-5789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARRAS",
        "first_name": "BROCK",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-05",
        "last_updated": "2016-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "LA",
            "license": "5622",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, LA

Sources for this page

Verify at the official NPI Registry.