DR. NICKOLAS STANLEY MASKAS (NPI# 1679913222) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679913222 |
| Entity Type | Individual |
| Full Name | DR. NICKOLAS STANLEY MASKAS |
| Credential | D.D.S. |
| Practice Address |
4720 Lake Street Lake Charles LA 70605 |
| Practice Telephone | 3378884771 |
| Practice Fax Number | 3378884772 |
| Mailing Telephone | 3378884771 |
| Mailing Fax Number | 3378884772 |
| Enumeration Date | 2013-06-27 |
| Last Update Date | 2019-12-20 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
6365 | LA | Dental Providers |
| N | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
1190 | FL | Dental Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1395 Center Dr # D7-6, Box 100416, Gainesville, FL 326100416 | 3522736750 | |
| 5656 Nelson Rd Ste C1, Lake Charles, LA 70605 | 3378884771 |
| Street Address |
4720 LAKE STREET |
| City | LAKE CHARLES |
| State | LA |
| Zip Code | 70605 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932759271 | Louisiana Oral & Implant Surgery | Clinic/Center | 4720 Lake Street, Lake Charles, LA 70605 | 2019-09-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780283606 | Kristin R Morris | Clinical Nurse Specialist | 1900 W. Gaythier Rd, Lake Charles, LA 70605 | 2020-10-21 |
| 1548871577 | Jacob M Theriot | Nurse Practitioner | 2640 County Club Rd., Lake Charles, LA 70605 | 2020-08-13 |
| 1053898403 | Heather Spallino Duplechain | Nurse Practitioner | 6713 Nelson Rd., Lake Charles, LA 70605 | 2018-07-27 |
| 1578057956 | Noor Deeb Weckerly | Nurse Practitioner | 6713 Nelson Rd, Lake Charles, LA 70605 | 2018-06-19 |
| 1861993354 | Therapy Works of Swla LLC | Physical Therapist | 4750 Lake Street, Lake Charles, LA 70605 | 2018-02-21 |
| 1669998852 | Amd Healthcare Lc, LLC | General Acute Care Hospital | 3730 Nelson Road, Lake Charles, LA 70605 | 2017-08-18 |
| 1619422474 | Kaitlyn Pinkerton | Specialist/Technologist | 800 E Mcneese St, Lake Charles, LA 70605 | 2016-08-22 |
| 1104274679 | Kelly Rogers | Counselor | 90 N. Luke 102l, Lafayette, LA 70605 | 2016-05-25 |
| 1548616220 | Lisa Monticello Snider | Neurological Surgery | 3297 Portrush Drive, Lake Charles, LA 70605 | 2016-05-11 |
| 1114387404 | Louisiana Dental Professionals, Donovan Dronet, Dds, A Professional De | Dentist | 4459 Nelson Rd, Suite 120, Lake Charles, LA 70605 | 2016-02-29 |
| Find all providers in zip 70605 | ||||
| Taxonomy Code | 1223S0112X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Surgery |
| The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871757187 | George Rawleigh Fisher | Dentist | 1624 Wolf Cir, Lake Charles, LA 70605 | 2008-07-16 |
| 1477527539 | Randolph Hunter Alexander | Dentist | 2708 Aster St, Suite A, Lake Charles, LA 70601-8824 | 2006-02-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346868676 | Cypress Bend Oral & Maxillofacial Surgery | Dentist | 106 Rue Bastille, Lafayette, LA 70508 | 2020-07-13 |
| 1578089603 | Ardoin-kennedy LLC | Dentist | 203 A Energy Parkway, Lafayette, LA 70508 | 2017-08-21 |
| 1932583358 | Oral Surgery& Dental Implant Center of Louisiana | Dentist | 16206 Airline Hwy, Prairieville, LA 70769-4248 | 2015-07-15 |
| 1588078224 | Ricardo Lugo | Dentist | 1501 Kings Hwy Rm 530, Shreveport, LA 71103-4228 | 2014-06-19 |
| 1184059818 | Yasser Saad Alali | Dentist | 5243 Butter Creek, Unit H7, Baton Rouge, LA 70809-0603 | 2013-09-12 |
| 1720354822 | John Ben Ragusa | Dentist | 16819 Cherry Bark Dr, Baton Rouge, LA 70810-5811 | 2012-03-22 |
| 1871882480 | Andrew Frederick Wetterlind | Dentist | 13730 Millerville Greens Blvd, Baton Rouge, LA 70816-1696 | 2011-04-04 |
| 1932415007 | Dr. David M. Vieth Dds, A Professional Corporation | Dentist | 91 Westbank Expy, Suite 345, Gretna, LA 70053-3615 | 2010-08-26 |
| 1548427693 | David Kyle Clark | Dentist | 2120 Bert Kouns Loop Ste D, Shreveport, LA 71118-3351 | 2008-05-16 |
| 1225204837 | David Bulot | Dentist | 411 Moncla Ave, Belle Chasse, LA 70037-2314 | 2008-05-03 |
| Find all providers with the same taxonomy | ||||
| City | LAKE CHARLES |
| Zip Code | 70605 |
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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.