Pediatric Dentist, PDC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

5132 Issued in LA

Legal business name

PEDIATRIC DENTIST, PDC

Practice address

2201 Veterans Memorial Blvd
Suite 306
Metairie, LA 70002

Phone

(504) 831-2120

Fax

(504) 831-2310

NPI assigned

Feb 27, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Jason D Parker, DDSNPI 1952517005

Title

President

Phone

(504) 669-8679

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jason D Parker, DDS

  • Pediatric Dentistry
  • Metairie, LA
  • NPI 1952517005
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1003943135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2201 VETERANS MEMORIAL BLVD",
            "address_2": "SUITE 306",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "70002",
            "telephone_number": "504-831-2120",
            "fax_number": "504-831-2310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2201 VETERANS MEMORIAL BLVD",
            "address_2": "SUITE 306",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "70002",
            "telephone_number": "504-831-2120",
            "fax_number": "504-831-2310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC DENTIST, PDC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PARKER",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "504-669-8679",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "LA",
            "license": "5132",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1851329",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Regina Celine Pearson-Bargeman
• Cassie Brassette Peart, N.P-C
• Alexia Peavy
• Karina Alyssa Pecaut
• Pediatria Healthcare, LLC (Aveanna Healthcare)
• Pediatric Services of America, LLC (Aveanna Healthcare)
• Pedro Romaguera, Apmc
• Escipion Pedroza, M.D.
• Claire Dianne Peebles, PH.D.
• Rade N. Pejic, M.D.

• Pediatric Dentistry in Metairie, LA
• Providers in Metairie, LA by specialty
• Pediatric Dentistry in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.