CENTRAL DENTAL CARE (NPI# 1609934488) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609934488 |
| Entity Type | Organization |
| Organization Name | CENTRAL DENTAL CARE |
| Practice Address |
11424 Sullivan Rd Bldg B Suite A Baton Rouge LA 70818-3615 |
| Mailing Address |
11424 Sullivan Road Bldg B Suite A Baton Rouge LA 70818 |
| Practice Telephone | 2252616645 |
| Practice Fax Number | 2252629061 |
| Mailing Telephone | 2252616645 |
| Mailing Fax Number | 2252629061 |
| Enumeration Date | 2006-12-05 |
| Last Update Date | 2008-07-14 |
| Authorized Official Name | JACOB F HENDERSON (OWNER) |
| Authorized Official Telephone | 2252616645 |
| Authorized Official Credential | D.D.S. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
5406 | LA | Dental Providers |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | CENTRAL DENTAL CARE | 1955 Central Ave, Mckinleyville, CA 95519-3605 |
| Street Address |
11424 SULLIVAN RD BLDG B SUITE A |
| City | BATON ROUGE |
| State | LA |
| Zip Code | 70818-3615 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205960424 | Jacob Francis Henderson | Dentist | 11424 Sullivan Rd Bldg B Suite A, Baton Rouge, LA 70817 | 2007-03-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508385576 | Stacia Clay | Driver | 8210 Brennen Drive, Baton Rouge, LA 70818 | 2017-09-11 |
| 1952650376 | Tara Rispone Delee | Social Worker | 12249 Hooper Road, Baton Rouge, LA 70818 | 2012-08-30 |
| 1417231705 | Cyril Floyd Broussard | Pharmacist | 14360 Wax Rd., Central, LA 70818 | 2011-10-05 |
| 1972887263 | Charles Erwin Seymour | Pharmacist | 14360 Wax Road, Central, LA 70818 | 2011-10-05 |
| 1306146089 | Central Chiropractic Center, Inc. | Preferred Provider Organization | 8755 Sullivan Road, Suite A, Central, LA 70818 | 2010-10-27 |
| 1649596321 | Fast Lane of Central LLC | Clinic/Center | 11421 Sullivan Rd, Bldg B, Baton Rouge, LA 70818 | 2010-04-20 |
| 1992837710 | James H Hebert | Dentist | 11424 Sullivan Road, Suite A, Baton Rouge, LA 70818 | 2007-03-09 |
| 1235295221 | Walter Jules Vaughan | Dentist | 13323 Hooper Rd., Baton Rouge, LA 70818 | 2006-12-28 |
| 1245329325 | Melissa R Barrett | Emergency Medicine | 11055 Shoe Creek Dr, Baton Rouge, LA 70818 | 2006-10-12 |
| 1740208867 | Michael Romaguera | Family Medicine | 11055 Shoe Creek Drive, Baton Rouge, LA 70818 | 2006-07-17 |
| Find all providers in zip 70818 | ||||
| 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 |
|---|---|---|---|---|
| 1609475128 | Exceptional Dental of Coursey, LLC | Dentist | 12045 Coursey Bvld., Baton Rouge, LA 70816 | 2020-10-26 |
| 1508465899 | Exceptional Dental of Highland, LLC | Dentist | 7278 Highland Rd Ste C, Baton Rouge, LA 70808-6604 | 2020-10-19 |
| 1033733746 | Michael P Juban Dds and J Cody Cowen North Apdllc | Dentist | 8670 Airline Highway, Suite A, Baton Rouge, LA 70815 | 2020-05-29 |
| 1659992865 | Justin K Bonaventure Dental Offices, LLC | Dentist | 13702 Coursey Blvd, Bldg 10, Ste C, Baton Rouge, LA 70817-1370 | 2020-04-28 |
| 1639646995 | Michael P Juban Dds and J Cody Cowen North Apdllc | Dentist | 554 Colonial Dr Ste B, Baton Rouge, LA 70806-6552 | 2018-10-25 |
| 1174009633 | Affordable Smiles of Baton Rouge, LLC | Dentist | 1962 Oneal Ln Ste A&b, Baton Rouge, LA 70816-3250 | 2018-07-17 |
| 1154814838 | Hollis Anne Clark | Dentist | 15420 S Harrells Ferry Rd Ste C, Baton Rouge, LA 70816-2933 | 2018-06-07 |
| 1033600804 | Kaitlyn Renee Hawkins | Dentist | 6860 Bluebonnet Blvd, Baton Rouge, LA 70810-1615 | 2018-05-28 |
| 1083136790 | Greesim Loy | Dentist | 13730 Millerville Greens Blvd Ste 1, Baton Rouge, LA 70816-1696 | 2017-07-13 |
| 1346760824 | Michael P Juban Dds and J Cody Cowen North LLC | Dentist | 3557 Monterrey Dr, Baton Rouge, LA 70814-2918 | 2017-06-26 |
| Find all providers in BATON ROUGE | ||||
| City | BATON ROUGE |
| Zip Code | 70818 |
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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.