B.R. Dental Specialists LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

B.R. DENTAL SPECIALISTS LLC

Practice address

3121 Maryland Ave
Kenner, LA 70065-4727

Phone

(504) 390-2847

NPI assigned

Apr 15, 2024

Last updated

Apr 15, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jaclyn Duboue, DDSNPI 1154409365

Title

Managing Member/ Dentist

Phone

(504) 390-2847

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jaclyn Duboue, DDS

  • General Practice Dentistry
  • Baton Rouge, LA
  • NPI 1154409365
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1713139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713139200000",
    "number": "1013761121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3121 MARYLAND AVE",
            "city": "KENNER",
            "state": "LA",
            "postal_code": "700654727",
            "telephone_number": "504-390-2847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3121 MARYLAND AVE",
            "city": "KENNER",
            "state": "LA",
            "postal_code": "700654727",
            "telephone_number": "504-390-2847"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "B.R. DENTAL SPECIALISTS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-15",
        "last_updated": "2024-04-15",
        "certification_date": "2024-04-15",
        "status": "A",
        "authorized_official_last_name": "DUBOUE",
        "authorized_official_first_name": "JACLYN",
        "authorized_official_title_or_position": "MANAGING MEMBER/ DENTIST",
        "authorized_official_telephone_number": "504-390-2847",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Michael Babin, PT
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• Gregory S Baird, CRNA

• Dental Clinic/Center in Kenner, LA
• Providers in Kenner, LA by specialty
• Dental Clinic/Center in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.