DR. ANDREW JOSEPH BROUILLETTE (NPI# 1972008332) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972008332 |
| Entity Type | Individual |
| Full Name | DR. ANDREW JOSEPH BROUILLETTE |
| Credential | DDS |
| Practice Address |
385 Bert Kouns Industrial Loop Ste 700 Shreveport LA 71106 |
| Mailing Address |
4956 Old Oak Dr Benton LA 71006-9366 |
| Practice Telephone | 3185247729 |
| Mailing Telephone | 3184580478 |
| Enumeration Date | 2018-03-28 |
| Last Update Date | 2018-06-11 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
6843 | LA | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | DRIVER'S LICENSE | 008580874 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2557 Viking Drive, Bossier City, LA 71111 | 3185247729 |
| Street Address |
385 BERT KOUNS INDUSTRIAL LOOP STE 700 |
| City | SHREVEPORT |
| State | LA |
| Zip Code | 71106 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548775885 | David Wayne Spears | Pharmacist | 10460 Norris Ferry Road, Shreveport, LA 71106 | 2017-12-08 |
| 1225559263 | Susan Anderson Roblow | Physical Therapist | 921 Unadilla Street, Shreveport, LA 71106 | 2017-06-29 |
| 1134656382 | James Lowder | Dentist | 8691 Line Ave Ste 300, Shreveport, LA 71106 | 2017-05-18 |
| 1144753708 | Laverne Brantley | Counselor | 328 E 69th St, Shreveport, LA 71106 | 2017-04-10 |
| 1437690849 | Biostat Laboratories, LLC | Clinical Medical Laboratory | 9742 Saint Vincent Ave Ste 200, Shreveport, LA 71106 | 2017-03-17 |
| 1841730728 | Cedric Thomas | Case Manager/Care Coordinator | 6811 Fairfield Avenue, Shreveport, LA 71106 | 2017-02-27 |
| 1225576192 | Nick Vergis | Pharmacist | 5828 Line Avenue, Shreveport, LA 71106 | 2017-02-10 |
| 1184162554 | Marilyn Johnson | Case Manager/Care Coordinator | 9245 Wallace Lake Rd Ste A, Shreveport, LA 71106 | 2017-02-06 |
| 1417499740 | Pamela Lee | Counselor | 8802 Coyth Ln, Shreveport, LA 71106 | 2016-11-17 |
| 1871044586 | Lester Jackson Jr. | Case Manager/Care Coordinator | 378 W. 79th St, Shreveport, LA 71106 | 2016-10-18 |
| Find all providers in zip 71106 | ||||
| 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 |
|---|---|---|---|---|
| 1003385899 | Scruggs Dental LLC | Dentist | 2001 E. 70th Street, Suite 105, Shreveport, LA 71005 | 2018-11-21 |
| 1679059539 | Michael E Woolbert Dds LLC | Dentist | 7600 Fern Avenue, Building 1100, Shreveport, LA 71105 | 2018-07-13 |
| 1003310053 | Erin O'neal | Dentist | 7030 Youree Dr Ste B, Shreveport, LA 71105-5109 | 2018-03-22 |
| 1487166450 | Emile T. Geneux IIdds, Benjamin A. Beach Dds, and Ross H. Dies Dds, Ll | Dentist | 2533 Bert Koun Loop Ste 107, Shreveport, LA 71118-3158 | 2017-10-31 |
| 1134656382 | James Lowder | Dentist | 8691 Line Ave Ste 300, Shreveport, LA 71106 | 2017-05-18 |
| 1720447147 | Dr. Monica A. Davenport, Dds Apc | Dentist | 1850 Martin Luther King Dr., Shreveport, LA 71107-5020 | 2016-02-12 |
| 1366822710 | A Brighter Smile | Dentist | 385 Bert Kouns Loop, Suite 700, Shreveport, LA 71106-8158 | 2015-06-01 |
| 1104250364 | Witte Family Dentistry, LLC | Dentist | 137 E Kings Hwy, Shreveport, LA 71104-3404 | 2013-08-23 |
| 1063792752 | Ivy Dental | Dentist | 460 Ashley Ridge Blvd Ste 600, Shreveport, LA 71106-7238 | 2011-08-25 |
| 1518290592 | Marian E Feducia | Dentist | 3503 Youree Dr, Shreveport, LA 71105-2119 | 2009-09-09 |
| Find all providers in SHREVEPORT | ||||
| City | SHREVEPORT |
| Zip Code | 71106 |
Please comment or provide details below to improve the information on DR. ANDREW JOSEPH BROUILLETTE.
| 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.