RAE A. GAUTHIER, DDS, LLC DBA PONCHATOULA FAMILY DENTISTRY (NPI# 1215446521) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215446521 |
| Entity Type | Organization |
| Organization Name | RAE A. GAUTHIER, DDS, LLC DBA PONCHATOULA FAMILY DENTISTRY |
| Practice Address |
430 E Pine St Ponchatoula LA 70454-2544 |
| Practice Telephone | (985) 687-3806 |
| Practice Fax Number | 9853868467 |
| Mailing Telephone | 9856873806 |
| Mailing Fax Number | 9853868467 |
| Enumeration Date | 2017-09-29 |
| Last Update Date | 2017-09-29 |
| Authorized Official Name | RAE ANN GAUTHIER (OWNER/DENTIST) |
| Authorized Official Telephone | 9853868454 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
5909 | LA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 1859095 | 05 |
| Street Address |
430 E PINE ST |
| City | PONCHATOULA |
| State | LA |
| Zip Code | 70454-2544 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861093478 | Alexis Kylie Spence | Physician Assistant | 1668 Us 51 N, Ponchatoula, LA 70454 | 2020-11-02 |
| 1982246740 | Stephanie R Mason | Pharmacist | 1331 Us-51 Bus, Ponchatoula, LA 70454 | 2019-10-14 |
| 1659879070 | Jessica Barrett | Behavioral Analyst | 21 Industrial Park Blvd Bldg A, Ponchatoula, LA 70454 | 2018-01-31 |
| 1124531397 | Mary F Smith | Counselor | 100 N 13th St, Ponchatoula, LA 70454 | 2017-11-09 |
| 1831625201 | Endia Geter | Counselor | 665 E Beech St, Ponchatoula, LA 70454 | 2017-05-04 |
| 1508392069 | Deep South Family Dentistry | Dentist | 1160 Hwy 51 North, Ponchatoula, LA 70454 | 2017-05-03 |
| 1720539299 | Evergreen Presbyterian Ministries, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 15212 Wadesboro Dr., Ponchatoula, LA 70454 | 2016-10-20 |
| 1376993360 | Latasha Williams | Counselor | 40048 Sugarberry Drive, Ponchatoula, LA 70454 | 2016-06-21 |
| 1770931503 | Evergreen Presbyterian Ministries, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 24345 Harvey Lavigne Road, Ponchatoula, LA 70454 | 2016-06-02 |
| 1881049211 | Evergreen Presbyterian Ministries, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 103 East Pecan St., Ponchatoula, LA 70454 | 2016-05-04 |
| Find all providers in zip 70454 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588135404 | Northshore Dental Associates LLC | Clinic/Center | 1160 Highway 51, Ponchatoula, LA 70454-6365 | 2018-12-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760082952 | Jimani Blackwell Dds LLC | Clinic/Center | 8015 Maple St, New Orleans, LA 70118-2738 | 2020-10-28 |
| 1578185096 | Dr. Raymond Poirrier Dds LLC | Clinic/Center | 1968 N Highway 190 Ste 11a, Covington, LA 70433-5158 | 2020-05-07 |
| 1851912711 | Covington Empower Orthodontics LLC - Dr Timothy M Poyadou Jr | Clinic/Center | 100 Tyler Sq Ste 4, Covington, LA 70433-3060 | 2020-05-01 |
| 1699314799 | Peach Tree Dental West Monroe, LLC | Clinic/Center | 3422 Cypress St, West Monroe, LA 71291-7310 | 2020-01-06 |
| 1538706015 | Exceptional Dental of Uptown, LLC | Clinic/Center | 5300 Tchoupitoulas St Ste F4, New Orleans, LA 70115-1963 | 2019-12-04 |
| 1447897186 | Affordable Smiles of Hammond, LLC | Clinic/Center | 2804 W Thomas St, Hammond, LA 70401-2841 | 2019-12-02 |
| 1528615887 | Benjamin A. Beach Dds and Ross H. Dies Dds Midcity, LLC | Clinic/Center | 8510 Line Ave Ste A, Shreveport, LA 71106-6119 | 2019-08-21 |
| 1295380418 | W. J. Dudley Denture Consultants | Clinic/Center | 4354 Pines Rd, Shreveport, LA 71119-7738 | 2019-08-05 |
| 1689226946 | Silver Lining Dentistry & Co. | Clinic/Center | 2305 West Esplanade Suit U, Kenner, LA 70065 | 2019-07-16 |
| 1790337632 | West Baton Rouge Dental Associates, LLC | Clinic/Center | 6572 Hwy 1 South, Addis, LA 70710 | 2019-07-11 |
| Find all providers with the same taxonomy | ||||
| City | PONCHATOULA |
| Zip Code | 70454 |
Please comment or provide details below to improve the information on RAE A. GAUTHIER, DDS, LLC DBA PONCHATOULA FAMILY DENTISTRY.
| 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.