NPIMap

Organization Active NPI

Audubon Family Dentistry

  • Dentist
  • Baton Rouge, LA
National Provider Identifier
1093179269
Registry record updated Apr 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
5276 Issued in LA
Legal business name
AUDUBON FAMILY DENTISTRY
Practice address
2925 Brakley Dr
Baton Rouge, LA 70816-2305
Phone
(225) 927-1515
Fax
(225) 928-3012
NPI assigned
Apr 13, 2016
Last updated
Apr 13, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2016

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

Authorized official

Name
Dr. Martha Roussel, DDS
Title
Co-Owner
Phone
(225) 927-1515

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 5276 LA Primary

Addresses

Primary practice location

2925 Brakley Dr
Baton Rouge, LA 70816-2305

Mailing address

2925 Brakley Dr
Baton Rouge, LA 70816-2305
Phone (225) 927-1515

National Provider Directory

National Provider Directory

Locations

2925 Brakley Dr
Baton Rouge, LA 70816
Phone (225) 927-1515

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1460505600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1460505600000",
    "number": "1093179269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2925 BRAKLEY DR",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708162305",
            "telephone_number": "225-927-1515",
            "fax_number": "225-928-3012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2925 BRAKLEY DR",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708162305",
            "telephone_number": "225-927-1515",
            "fax_number": "225-928-3012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AUDUBON FAMILY DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-13",
        "last_updated": "2016-04-13",
        "status": "A",
        "authorized_official_last_name": "ROUSSEL",
        "authorized_official_first_name": "MARTHA",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "225-927-1515",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "LA",
            "license": "5276",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baton Rouge, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2016; 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.