NPIMap

Organization Active NPI

Ross H. Dies, J. Cody Cowen, DDS, Benjamin a. Beach, DDS and Bryan Ste

Doing business as Shreveport Bossier Family Dental Care

  • Pediatric Dentistry
  • Bossier City, LA
National Provider Identifier
1972056638
Registry record updated Jul 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
4273 Issued in LA
Legal business name
ROSS H. DIES, J. CODY COWEN, DDS, BENJAMIN A. BEACH, DDS AND BRYAN STE
Doing business as
Shreveport Bossier Family Dental Care
Practice address
3412 Barksdale Blvd
100
Bossier City, LA 71112-3800
Phone
(318) 686-7470
Fax
(318) 686-4505
NPI assigned
Jul 29, 2016
Last updated
Jul 29, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2016

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

Authorized official

Name
Dr. Ross Dies, DDSNPI 1457455008
Title
Owner
Phone
(318) 213-4686

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0221X 4273 LA Primary

Addresses

Primary practice location

3412 Barksdale Blvd
100
Bossier City, LA 71112-3800

Mailing address

3412 Barksdale Blvd
100
Bossier City, LA 71112-3800
Phone (318) 686-7470

Other names 1

  • Shreveport Bossier Family Dental Care Doing business as

National Provider Directory

National Provider Directory

Locations

3412 Barksdale Blvd
Ste 100
Bossier City, LA 71112
Phone (318) 686-7470

Practitioners & affiliated clinicians

Practitioners 1

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": "1469750400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1469750400000",
    "number": "1972056638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3412 BARKSDALE BLVD",
            "address_2": "100",
            "city": "BOSSIER CITY",
            "state": "LA",
            "postal_code": "711123800",
            "telephone_number": "318-686-7470",
            "fax_number": "318-686-4505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3412 BARKSDALE BLVD",
            "address_2": "100",
            "city": "BOSSIER CITY",
            "state": "LA",
            "postal_code": "711123800",
            "telephone_number": "318-686-7470",
            "fax_number": "318-686-4505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROSS H. DIES, J. CODY COWEN, DDS, BENJAMIN A. BEACH, DDS AND BRYAN STE",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-29",
        "last_updated": "2016-07-29",
        "status": "A",
        "authorized_official_last_name": "DIES",
        "authorized_official_first_name": "ROSS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "318-213-4686",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "LA",
            "license": "4273",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shreveport Bossier Family Dental Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bossier City, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2016; 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.