Thorson Dentistry for Kids

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

THORSON DENTISTRY FOR KIDS

Practice address

159 Longview Dr Ste a
Destrehan, LA 70047

Phone

(985) 307-0072

NPI assigned

Aug 7, 2018

Organization subpart

No

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

Authorized official

Name

Joey Keener

Title

Office Manager

Phone

(985) 307-0072

Specialties & licenses 1

Addresses

Other identifiers 4

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

{
    "created_epoch": "1533600000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1534291200000",
    "number": "1124507611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "159 LONGVIEW DR STE A",
            "city": "DESTREHAN",
            "state": "LA",
            "postal_code": "700475076",
            "telephone_number": "985-307-0072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "159 LONGVIEW DR STE A",
            "city": "DESTREHAN",
            "state": "LA",
            "postal_code": "70047",
            "telephone_number": "985-307-0072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THORSON DENTISTRY FOR KIDS",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-07",
        "last_updated": "2018-08-15",
        "status": "A",
        "authorized_official_last_name": "KEENER",
        "authorized_official_first_name": "JOEY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "985-307-0072"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1861227",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "6122",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "26622",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "28782",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Robert Nathan Smith, NP
• William James Smith, PT, DPT, OCS, CSCS
• Heather Stephens, MS, L-SLP, CCC-SLP
• Larry Joe Stiger, RPH
• The Specialist Group
• Elizabeth Thorson, D.D.S
• Victoria Hall Townsend, LCSW
• Melissa Arceneaux Vinterella, D.C.
• Sherry Ward
• Sandra Kaaz Warner, O.D.

• Pediatric Dentistry in Destrehan, LA
• Providers in Destrehan, 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 15, 2018; 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.