Bennett P. Fontenot

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2964 Issued in LA

Practice address

1329 Grand Pointe Ave.
Breaux Bridge, LA 70517

Phone

(337) 332-2412

Fax

(337) 332-5159

NPI assigned

Jan 4, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Breaux Bridge Family Dentisrty

  • Dentist
  • Breaux Bridge, LA
  • NPI 1386099281
  NPD (past)

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

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1962559609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1329 GRAND POINTE AVE.",
            "city": "BREAUX BRIDGE",
            "state": "LA",
            "postal_code": "70517",
            "telephone_number": "337-332-2412",
            "fax_number": "337-332-5159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1329 GRAND POINTE AVE.",
            "city": "BREAUX BRIDGE",
            "state": "LA",
            "postal_code": "70517",
            "telephone_number": "337-332-2412",
            "fax_number": "337-332-5159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FONTENOT",
        "first_name": "BENNETT",
        "middle_name": "P.",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "LA",
            "license": "2964",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1829641",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Equipped for the Journey, Inc.
• Ermias Care Transport LLC
• Shaneka Evans, APRN
• Exotic Expressions Inc.
• Extended Family Inc
• Jessica M. Fontenot
• Morgan Lain Fontenot, MS, PLPC
• Micheal Frank Sr.
• Leroy J Frederick, PD
• Fuselier Healthcare Services, LLC

• General Practice Dentistry in Breaux Bridge, LA
• Providers in Breaux Bridge, 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 Jul 8, 2007; 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.