EXCEPTIONAL DENTAL OF KENNER


Address: 1305 W Esplanade Ave, Kenner, LA 70065-2744
Phone: 5044696333

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).

Provider Overview

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

Taxonomy

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

Office Location

Street Address 1305 W ESPLANADE AVE
City KENNER
State LA
Zip Code 70065-2744

Providers in the same location

NPI Name Taxonomy Address Enumeration
1427549872 Cody Brignac Dentist 1305 W Esplanade Ave, Kenner, LA 70065-2744 2018-05-22

Providers in the same zip code

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 Information

Taxonomy Code 1223G0001X
Grouping Dental Providers
Classification Dentist
Specialization General Practice

Taxonomy Definition

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

Providers in the same taxonomy and city

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

Competitor

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City KENNER
Zip Code 70065

Improve Information

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Dataset Information

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.

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