ELLIS D. BRAUD AND FRED A. TENNEY (NPI# 1275061079) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275061079 |
| Entity Type | Organization |
| Organization Name | ELLIS D. BRAUD AND FRED A. TENNEY |
| Practice Address |
810 Bayou Ln Thibodaux LA 70301-4906 |
| Practice Telephone | (985) 446-2888 |
| Practice Fax Number | 9854471007 |
| Mailing Telephone | 9854462888 |
| Mailing Fax Number | 9854471007 |
| Enumeration Date | 2017-05-24 |
| Last Update Date | 2017-06-09 |
| Authorized Official Name | DR. ELLIS DAVID BRAUD JR. (PRESIDENT) |
| Authorized Official Telephone | 9854462888 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
LA | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 29215 | 05 | |
| LA | 29633 | 05 |
| Street Address |
810 BAYOU LN |
| City | THIBODAUX |
| State | LA |
| Zip Code | 70301-4906 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194291146 | Acadia Family Dentistry | Clinic/Center | 810 Bayou Ln, Thibodaux, LA 70301-4906 | 2018-10-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225539620 | Micah Aaron Callais | Nurse Practitioner | 604 N. Acadia Road, Suite 200, Thibodaux, LA 70301 | 2018-02-22 |
| 1982112348 | Katie Leblanc | Massage Therapist | 1115 St. Mary Street, Thibodaux, LA 70301 | 2018-01-18 |
| 1154837391 | Texas Digestive Disease Consultants, Pllc | Internal Medicine | 764 North Acadia Road, Suite A, Thibodaux, LA 70301 | 2017-12-26 |
| 1235648239 | Speech and Feeding Therapy, LLC | Speech-Language Pathologist | 1000 Plantation Rd Ste 1a, Thibodaux, LA 70301 | 2017-09-22 |
| 1285150466 | Tara Payne | Counselor | 303 Hickory Street, Thibodaux, LA 70301 | 2017-08-18 |
| 1427583475 | Tyler Pettigrew | Counselor | 300 Plantation Rd., Apt #24, Thibodaux, LA 70301 | 2017-04-27 |
| 1750825758 | Jessica Barquet | Counselor | 110 Palm Villa Dr Apt 1, Thibodaux, LA 70301 | 2016-12-09 |
| 1013468230 | Shenee Haas Gros | Counselor | 504 Cherry St., Thibodaux, LA 70301 | 2016-10-24 |
| 1982155388 | Southern Ent Associates Inc | Audiologist | 604 North Acadia Road Suite 101, Thibodaux, LA 70301 | 2016-10-20 |
| 1215483888 | Lesheeca Norman, Lpc | Counselor | 306 Victoria Court, Thibodaux, LA 70301 | 2016-09-01 |
| Find all providers in zip 70301 | ||||
| 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 |
|---|---|---|---|---|
| 1003392234 | Aimee Dupree Ledet | Dentist | 900 N Canal Blvd Ste 1, Thibodaux, LA 70301-8096 | 2018-07-11 |
| 1245646652 | James Terrebonne | Dentist | 850 North Canal Blvd, Thibodaux, LA 70301 | 2014-07-07 |
| 1205158953 | Brian Michael Roundtree | Dentist | 705 Plantation Rd, Thibodaux, LA 70301-4303 | 2010-02-23 |
| 1356561575 | Ellis David Braud Jr. | Dentist | 810 Bayou Lane, Thibodaux, LA 70301-4906 | 2007-04-27 |
| 1952421497 | Michael Frances Leblanc Sr. | Dentist | 900 Canal Blvd Ste 1, Thibodaux, LA 70301-4506 | 2007-03-29 |
| 1043339716 | Sheard Adolph Ber | Dentist | 1711 Himalaya Ave, Thibodaux, LA 70301-5309 | 2007-03-27 |
| 1346372539 | Edward Drew Clement | Dentist | 117 Saint Michael St, Thibodaux, LA 70301-3437 | 2007-03-12 |
| 1750430039 | Larry J Verdun | Dentist | 1001b E 7th St, Thibodaux, LA 70301-3610 | 2007-01-09 |
| 1467513192 | James Louis Danos | Dentist | 305 East First St, Thibodaux, LA 70301-3341 | 2006-12-13 |
| 1679652044 | David Louis Oncale | Dentist | 705 Plantation Road, Thibodaux, LA 70301 | 2006-11-04 |
| Find all providers in THIBODAUX | ||||
Please comment or provide details below to improve the information on ELLIS D. BRAUD AND FRED A. TENNEY.
| 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.