Grand Family Dentistry Abita Springs LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

GRAND FAMILY DENTISTRY ABITA SPRINGS LLC

Practice address

22464 La Hwy 435
Abita Springs, LA 70420-2206

Phone

(985) 893-7835

Fax

(985) 778-0301

NPI assigned

Jan 7, 2025

Organization subpart

No

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

Authorized official

Name

Mary Cotton

Title

Accountant

Phone

(985) 778-0096

Specialties & licenses 1

Addresses

Locations

Practitioners 3

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

• Shannon Elizabeth Roussell

  • General Practice Dentistry
  • Abita Springs, LA
  • NPI 1316739121
  NPD
• Eduardo Menendez, DDS

  • General Practice Dentistry
  • Abita Springs, LA
  • NPI 1396875324
  NPD (past)
• Nicole Suberville Wascom, D.D.S.

  • Dentist
  • Abita Springs, LA
  • NPI 1982807632
  NPD (past)

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

{
    "created_epoch": "1736208000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736208000000",
    "number": "1114736774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 ASBURY DR",
            "city": "MANDEVILLE",
            "state": "LA",
            "postal_code": "704711844",
            "telephone_number": "985-778-0096",
            "fax_number": "985-778-0301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22464 LA HWY 435",
            "city": "ABITA SPRINGS",
            "state": "LA",
            "postal_code": "704202206",
            "telephone_number": "985-893-7835",
            "fax_number": "985-778-0301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRAND FAMILY DENTISTRY ABITA SPRINGS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-01-07",
        "last_updated": "2025-01-07",
        "certification_date": "2025-01-07",
        "status": "A",
        "authorized_official_last_name": "COTTON",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "ACCOUNTANT",
        "authorized_official_telephone_number": "985-778-0096"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda Lake Faulkner, RN
• Danielle Chiasson Fitzpatrick, RN
• Heather Fontenot
• Hannah Abigail Forrest
• Donna Shartil Golman
• Patrick Hammett, LPC
• Hallie Harper, PLPC
• Amanda Haverfield
• Donald Eugene Henry
• Honey Bee Speech Therapy & Rehab LLC

• General Practice Dentistry in Abita Springs, LA
• Providers in Abita Springs, LA by specialty
• General Practice Dentistry in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2025; 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.