BILLY MELVIN DESOTO (NPI# 1124181235) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124181235 |
| Entity Type | Individual |
| Full Name | BILLY MELVIN DESOTO |
| Credential | D.D.S. |
| Practice Address |
2515 Southside Dr Shreveport LA 71118-2120 |
| Practice Telephone | 3186866411 |
| Practice Fax Number | 3186865187 |
| Mailing Telephone | 3186866411 |
| Mailing Fax Number | 3186865187 |
| Enumeration Date | 2006-12-19 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223X0400X |
Dentist Specialization: Orthodontics and Dentofacial Orthopedics |
2098 | LA | Dental Providers |
| Street Address |
2515 SOUTHSIDE DR |
| City | SHREVEPORT |
| State | LA |
| Zip Code | 71118-2120 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720620784 | Wk Center for Pediatric Gastroenterology | Pediatrics | Wk Center for Pediatric Gastroenterology, 2530 Bert Kouns Industrial Loop, Ste 113, Shreveport, LA 71118 | 2019-10-11 |
| 1306302443 | Diamond Marie Willis | Case Manager/Care Coordinator | 9403 Mansfield Rd., Shreveport, LA 71118 | 2019-02-13 |
| 1194224469 | Latosa Hall | Case Manager/Care Coordinator | 9007 Letha Loop, Shreveport, LA 71118 | 2018-02-01 |
| 1902321623 | Bersheika Lashay Player | Counselor | 9403 Mansfield Road, Shreveport, LA 71118 | 2017-08-03 |
| 1518487149 | Clarke Jackson | Case Manager/Care Coordinator | 9730 Baird Rd Apt 2310, Shreveport, LA 71118 | 2017-06-24 |
| 1770010449 | Darrie'l Smith | Counselor | 2715 Mackey, Shreveport, LA 71118 | 2017-05-12 |
| 1760917041 | Delilah Wells | Case Manager/Care Coordinator | 9005 Walker Rd Apt 722, Shreveport, LA 71118 | 2017-04-25 |
| 1790229664 | We Care Transporttion Services LLC | Secured Medical Transport (VAN) | 2529 Summer Grove Dr, Shreveport, LA 71118 | 2016-12-13 |
| 1063955128 | Commanisha Smith | Social Worker | 2715 Mackey Place, Shreveport, LA 71118 | 2016-11-22 |
| 1023560802 | Yasmin Newman | Counselor | 9812 West Trails End, Shreveport, LA 71118 | 2016-10-27 |
| Find all providers in zip 71118 | ||||
| Taxonomy Code | 1223X0400X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Orthodontics and Dentofacial Orthopedics |
| That area of dentistry concerned with the supervision, guidance and correction of the growing or mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships and malformations of their related structures and the adjustment of relationships between and among teeth and facial bones by the application of forces and/or the stimulation and redirection of functional forces within the craniofacial complex. Major responsibilities of orthodontic practice include the diagnosis, prevention, interception and treatment of all forms of malocclusion of the teeth and associated alterations in their surrounding structures; the design, application and control of functional and corrective appliances; and the guidance of the dentition and its supporting structures to attain and maintain optimum occlusal relations in physiologic and esthetic harmony among facial and cranial structures. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528674116 | Allison Haynie | Dentist | 1914 E 70th St Ste H, Shreveport, LA 71105-5312 | 2020-09-18 |
| 1689862260 | H. O. Blackwood, D.d.s. Apdc | Dentist | 814 Pierremont Rd, Shreveport, LA 71106-2034 | 2007-10-09 |
| 1871783886 | Richard T Nelson IIi | Dentist | 7878 Jefferson Paige Rd, Shreveport, LA 71119-8865 | 2007-07-26 |
| 1447383989 | William Clayton Cook | Dentist | 310 Carroll St, Shreveport, LA 71105-4132 | 2007-03-13 |
| 1073899001 | Benjamin Cole Foster | Dentist | 1914 E 70th St, Shreveport, LA 71105-5312 | 2011-10-21 |
| 1922235597 | Peter H. Nasser | Dentist | 9091 Ellerbe Rd, Suite 500, Shreveport, LA 71106-6738 | 2009-06-22 |
| 1902014343 | Jeffrey W Silmon | Dentist | 230 Carroll St, Ste 1, Shreveport, LA 71105-4248 | 2007-05-18 |
| 1093923427 | Christopher C Cosse | Dentist | 230 Carroll St, Ste 1, Shreveport, LA 71105-4248 | 2007-05-18 |
| 1851512388 | Louisiana Orthodontic Specialists | Dentist | 2530 Bert Kouns Industrial Loop, Suite 112, Shreveport, LA 71118-3132 | 2007-05-01 |
| 1346468469 | Ernest Cecil Farabee IIi | Dentist | 2530 Bert Kouns Industrial Loop, Suite 112, Shreveport, LA 71118-3132 | 2007-04-23 |
| Find all providers in SHREVEPORT | ||||
| City | SHREVEPORT |
| Zip Code | 71118 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.