EXCEPTIONAL DENTAL OF KENNER (NPI# 1194035352) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194035352 |
| Entity Type | Organization |
| Organization Name | EXCEPTIONAL DENTAL OF KENNER |
| Practice Address |
1305 W Esplanade Ave Kenner LA 70065-2744 |
| Practice Telephone | 5044696333 |
| Practice Fax Number | 5044696355 |
| Mailing Telephone | 5044696333 |
| Mailing Fax Number | 5044696355 |
| Enumeration Date | 2010-10-20 |
| Last Update Date | 2015-12-08 |
| Authorized Official Name | DR. DARRELL PHILIP BOURG JR. (DENTIST/OWNER) |
| Authorized Official Telephone | 5044696333 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QD0000X |
Clinic/Center Specialization: Dental |
5312 | LA | Ambulatory Health Care Facilities |
| Y | 1223G0001X |
Dentist Specialization: General Practice |
Dental Providers |
| Street Address |
1305 W ESPLANADE AVE |
| City | KENNER |
| State | LA |
| Zip Code | 70065-2744 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427549872 | Cody Brignac | Dentist | 1305 W Esplanade Ave, Kenner, LA 70065-2744 | 2018-05-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689226946 | Silver Lining Dentistry & Co. | Clinic/Center | 2305 West Esplanade Suit U, Kenner, LA 70065 | 2019-07-16 |
| 1912462615 | Tamiqua Monique Torres | Lactation Consultant, Non-RN | 4129 Idaho Ave #a, Kenner, LA 70065 | 2019-02-06 |
| 1649766650 | Kenner Dental Associates, LLC | Dentist | 1501 32nd St., Kenner, LA 70065 | 2018-07-03 |
| 1194216465 | Shanne Gilbert | Technician, Pathology | Kenner Metairie and Surrounding Areas, Kenner, LA 70065 | 2018-05-23 |
| 1437668597 | Jbl Rx LLC | Pharmacy | 2305 West Esplanade Ave, Suite T, Kenner, LA 70065 | 2017-09-21 |
| 1073049532 | Jonathan English | Counselor | 3701 Tulane Dr, Kenner, LA 70065 | 2017-05-03 |
| 1033644752 | Fonteno Services LLC | Non-emergency Medical Transport (VAN) | 3017 Huntsville, St, Kenner, LA 70065 | 2017-05-01 |
| 1821521915 | Shondreca Nicole Sanders | Counselor | 4520 Williams Blvd, #y383, Kenner, LA 70065 | 2017-04-06 |
| 1225570104 | Dominiece Lacroix | Nurse Practitioner | 3616 Loyola Drive, 271, Kenner, LA 70065 | 2016-11-09 |
| 1427506286 | Lisandra Nunez | Counselor | 153 Auburn Pl, Kenner, LA 70065 | 2016-09-21 |
| Find all providers in zip 70065 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093330631 | Seaira-myangel Emily Miles | Dentist | 3569 W Louisiana State Dr, Kenner, LA 70065-2451 | 2020-06-09 |
| 1841852795 | Samra Naeem | Dentist | 1501 32nd St, Kenner, LA 70065-3204 | 2019-07-01 |
| 1932695046 | Chedly Schatzie Vincent Dmd LLC | Dentist | 2240 Veterans Memorial Blvd, Kenner, LA 70062-5463 | 2018-07-02 |
| 1184934846 | Acadia Health, LLC | Dentist | 2526 Williams Blvd, Kenner, LA 70062 | 2010-10-15 |
| 1164696480 | Samer Salti | Dentist | 1201 W Esplanade Ave, Apt 611, Kenner, LA 70065-6246 | 2008-04-17 |
| 1851418289 | Roland Antoine Caire Jr. | Dentist | 4315 Williams Blvd, Kenner, LA 70065-2206 | 2007-03-22 |
| 1861559635 | Elizabeth Troendle | Dentist | 3229 Florida Ave, Kenner, LA 70065-3642 | 2007-01-02 |
| 1225112121 | James D Roethele | Dentist | 283 W Esplanade Ave, Kenner, LA 70065-2459 | 2006-10-25 |
| 1124111935 | Larry A Wise | Dentist | 909 W Esplanade Ave, Suite 101, Kenner, LA 70065-2700 | 2006-10-02 |
| 1881656403 | Wynn Christopher Russo | Dentist | 2301 Williams Blvd, Kenner, LA 70062-5721 | 2006-04-06 |
| Find all providers in KENNER | ||||
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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.