NPIMap

Organization Active NPI

Phillip L Stelly DDS

  • Dentist
  • Carencro, LA
National Provider Identifier
1932227113
Registry record updated Oct 1, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
4453 Issued in LA
Legal business name
PHILLIP L STELLY DDS
Practice address
258 Arceneaux Rd
Carencro, LA 70520
Phone
(337) 896-9132
Fax
(337) 896-7852
NPI assigned
Mar 27, 2007
Last updated
Oct 1, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2007

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

Authorized official

Name
Dr. Phillip L Stelly, DDSNPI 1447378526
Title
Owner Dentist
Phone
(337) 896-3267

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 4453 LA Primary

Addresses

Primary practice location

258 Arceneaux Rd
Carencro, LA 70520

Mailing address

258 Arceneaux Rd
Carencro, LA 70520
Phone (337) 896-3267

Other identifiers 1

IdentifierTypeStateIssuer
1844535MedicaidLA

Other names 1

  • Phillip L Stelly DDS A Professionel Dental Corp Other name

National Provider Directory

National Provider Directory

Locations

258 Arceneaux Rd
Carencro, LA 70520
Phone (337) 896-3267

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191196800000",
    "number": "1932227113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "258 ARCENEAUX RD",
            "city": "CARENCRO",
            "state": "LA",
            "postal_code": "70520",
            "telephone_number": "337-896-3267",
            "fax_number": "337-896-7852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "258 ARCENEAUX RD",
            "city": "CARENCRO",
            "state": "LA",
            "postal_code": "70520",
            "telephone_number": "337-896-9132",
            "fax_number": "337-896-7852"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHILLIP L STELLY DDS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-27",
        "last_updated": "2007-10-01",
        "status": "A",
        "authorized_official_last_name": "STELLY",
        "authorized_official_first_name": "PHILLIP",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER DENTIST",
        "authorized_official_telephone_number": "337-896-3267",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "LA",
            "license": "4453",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1844535",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Phillip L Stelly DDS A Professionel Dental Corp",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Carencro, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.