Individual provider Active NPI

Daniel A Weaver, DDS

  • Dentist
  • Lake Charles, LA
National Provider Identifier
1962425538
Registry record updated Dec 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
5219 Issued in LA
Practice address
715 W College St
Lake Charles, LA 70605-1523
Phone
(337) 478-3123
Fax
(337) 478-3229
NPI assigned
Jul 25, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 8, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 5219 LA Primary

Addresses

Primary practice location

715 W College St
Lake Charles, LA 70605-1523

Mailing address

715 W College St
Lake Charles, LA 70605-1523
Phone (337) 478-3123

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
I20150617001217 LA Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 7113238197

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5219LAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Sleep Remedy LLC General Practice CurrentSince Oct 2, 2022 Accepting new patients
Dr Daniel Andrew Weaver Professional Dental Corporation General Practice Current Accepting new patients

Locations

715 W College St
Lake Charles, LA 70605
Phone (337) 478-3123

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.

NPI Registry JSON

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765152000000",
    "number": "1962425538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "715 W COLLEGE ST",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706051523",
            "telephone_number": "337-478-3123",
            "fax_number": "337-478-3229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 W COLLEGE ST",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706051523",
            "telephone_number": "337-478-3123",
            "fax_number": "337-478-3229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEAVER",
        "first_name": "DANIEL",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-25",
        "last_updated": "2025-12-08",
        "certification_date": "2025-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "LA",
            "license": "5219",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Charles, LA

Sources for this page

Verify at the official NPI Registry.