NPIMap

Organization Active NPI

Shane Tewis, DDS of Louisiana, a Professional Dental LLC

Doing business as Affordable Dentures & Implants - Carencro

  • General Practice Dentistry
  • Carencro, LA
National Provider Identifier
1962870493
Registry record updated Apr 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
SHANE TEWIS, DDS OF LOUISIANA, A PROFESSIONAL DENTAL LLC
Doing business as
Affordable Dentures & Implants - Carencro
Practice address
114 Derek Plaza
Ste E
Carencro, LA 70520
Phone
(337) 520-0196
NPI assigned
Sep 15, 2015
Last updated
Apr 13, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2026

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

Authorized official

Name
Haley Wooster
Title
Enrollment Manager
Phone
(984) 251-8846

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 6219 LA
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

114 Derek Plaza
Ste E
Carencro, LA 70520

Mailing address

114 Derek Plaza Dr Ste E
Carencro, LA 70520-3644
Phone (337) 520-0196

Other names 1

  • Affordable Dentures & Implants - Carencro Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Affordable Dentures Implants - Carencro5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

114 Derek Plaza Dr
Ste E
Carencro, LA 70520
Phone (337) 520-0196

NPI Registry JSON

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

{
    "created_epoch": "1442275200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1776038400000",
    "number": "1962870493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 DEREK PLAZA DR STE E",
            "city": "CARENCRO",
            "state": "LA",
            "postal_code": "705203644",
            "telephone_number": "337-520-0196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 DEREK PLAZA",
            "address_2": "STE E",
            "city": "CARENCRO",
            "state": "LA",
            "postal_code": "70520",
            "telephone_number": "337-520-0196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHANE TEWIS, DDS OF LOUISIANA, A PROFESSIONAL DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-15",
        "last_updated": "2026-04-13",
        "certification_date": "2026-04-13",
        "status": "A",
        "authorized_official_last_name": "WOOSTER",
        "authorized_official_first_name": "HALEY",
        "authorized_official_title_or_position": "ENROLLMENT MANAGER",
        "authorized_official_telephone_number": "984-251-8846"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "LA",
            "license": "6219",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Affordable Dentures & Implants - Carencro",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Apr 13, 2026; 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.