Katie Courville Roberts, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

6351 Issued in LA

Practice address

3632 Common St
Lake Charles, LA 70607-1744

Phone

(337) 478-4022

Fax

(337) 478-4017

NPI assigned

May 20, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1369008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464912000000",
    "number": "1952747719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3632 COMMON ST",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706071744",
            "telephone_number": "337-478-4022",
            "fax_number": "337-478-4017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3632 COMMON ST",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706071744",
            "telephone_number": "337-478-4022",
            "fax_number": "337-478-4017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "KATIE",
        "middle_name": "COURVILLE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-20",
        "last_updated": "2016-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "LA",
            "license": "6351",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Neisha Roberson
• Robert C Cochran DDS, LLC (Moss Bluff Family Dental Care)
• Brenda Faye Roberts, EDD
• Demond Roberts
• Joshua Paul Roberts
• Rhiannon Lea Roberts, LMT
• Troy Robertson
• Robinson Dental Group
• Robinson Dental Group
• Briaunna Nicole Robinson

• General Practice Dentistry in Lake Charles, LA
• Providers in Lake Charles, LA by specialty
• General Practice Dentistry in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.