Lsu Health Sciences Center Lsu Faculty Dental Practice

Primary specialty

Oral and Maxillofacial Pathology DentistryTaxonomy code 1223P0106X

License

5003 Issued in LA

Legal business name

LSU HEALTH SCIENCES CENTER LSU FACULTY DENTAL PRACTICE

Practice address

1100 Florida Ave
Box 131
New Orleans, LA 70119-2714

Phone

(504) 619-8721

Fax

(504) 941-8001

NPI assigned

May 2, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Sue H. Speegle, CPA

Title

Practice Manager

Phone

(504) 941-8119

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

Tax ID family

Lsu Health Sciences Center Lsu Faculty Dental Practice2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Lsu Health Sciences Center Lsu Faculty Dental Practice

  • Pediatric Dentistry
  • Metairie, LA
  • NPI 1528280641
  NPD tax ID

Locations

Practitioners 2

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

• Molly Susan Rosebush, DDS, MS

  • Oral and Maxillofacial Pathology Dentistry
  • New Orleans, LA
  • NPI 1992835060
  Medicare reassignment Care Compare group NPD
• Kitrina G Cordell, DDS MS

  • Oral and Maxillofacial Pathology Dentistry
  • New Orleans, LA
  • NPI 1558494559
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1178064000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1406073600000",
    "number": "1154543288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 FLORIDA AVE",
            "address_2": "BOX 131",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701192714",
            "telephone_number": "504-619-8721",
            "fax_number": "504-941-8001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 FLORIDA AVE",
            "address_2": "BOX 131",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701192714",
            "telephone_number": "504-619-8721",
            "fax_number": "504-941-8001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LSU HEALTH SCIENCES CENTER LSU FACULTY DENTAL PRACTICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-02",
        "last_updated": "2014-07-23",
        "status": "A",
        "authorized_official_last_name": "SPEEGLE",
        "authorized_official_first_name": "SUE",
        "authorized_official_middle_name": "H.",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "504-941-8119",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "CPA"
    },
    "taxonomies": [
        {
            "code": "1223P0106X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Pathology",
            "state": "LA",
            "license": "5003",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "A8122",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1952702",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• LRT, LLC
• Lsu Ambulatory Surgery Center
• Lsu Health Ambulatory Surgery Center, LLC
• Lsu Health New Orleans
• Lsu Health Sciences Center
• Lsu Health Sciences Center School of Nursing
• Lsu Healthcare Network
• Lsu Healthcare Network
• Lsu Healthcare Network Eye Center
• Lsu HSC

• Oral and Maxillofacial Pathology Dentistry in New Orleans, LA
• Providers in New Orleans, LA by specialty
• Oral and Maxillofacial Pathology Dentistry in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2014; 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.