DUSTIN THOMAS LANDGRAVE DO NPI 1588314892

NPI Information

  • NPI: 1588314892
  • Provider Name: DUSTIN THOMAS LANDGRAVE, DO
  • Classification: Family Medicine - 207QA0505X
  • Specialization: Adult Medicine
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 1111 N CAUSEWAY BLVD
    MANDEVILLE, LA
    ZIP 70471
  • Phone: (985) 674-4464

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NPI Details

Dustin Thomas Landgrave, DO is an adult medicine family medicine in Mandeville, LA with 4 years of experience. The provider is the National Uniform Claim Committee (NUCC) recommends code 207QA0505X not be used. Choose a more appropriate code. Dustin Thomas Landgrave, DO NPI is 1588314892. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: WILLIAM CAREY UNIVERSITY COLLEGE OF OSTEOPATHIC MEDICINE
Graduation Year:2022

The provider's business location address is:

1111 N CAUSEWAY BLVD
MANDEVILLE, LA
ZIP 70471-409
Phone: (985) 674-4464

The NPI 1588314892 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 3/28/2022 and was last updated on 6/26/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1390200000XStudent in an Organized Health Care Education/Training ProgramNo
2207QA0505XFamily MedicineAdult Medicine344606LOUISIANAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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