NPIMap

Organization Active NPI

Corey a. Robertson, a Professional Dental Corporation

  • Dentist
  • Baton Rouge, LA
National Provider Identifier
1174668644
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
4907 Issued in LA
Legal business name
COREY A. ROBERTSON, A PROFESSIONAL DENTAL CORPORATION
Practice address
9745 Airline Hwy
Baton Rouge, LA 70816-8101
Phone
(225) 201-0511
NPI assigned
Feb 21, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Corey A Robertson, DDSNPI 1326195348
Title
Owner
Phone
(225) 201-0511

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 4907 LA Primary

Addresses

Primary practice location

9745 Airline Hwy
Baton Rouge, LA 70816-8101

Mailing address

9745 Airline Hwy
Baton Rouge, LA 70816-8101
Phone (225) 201-0511

National Provider Directory

National Provider Directory
Tax ID family
Corey a Robertson a Professional Dental Corporation2 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.

Locations

9745 Airline Hwy
Baton Rouge, LA 70816
Phone (225) 201-0511

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1174668644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9745 AIRLINE HWY",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708168101",
            "telephone_number": "225-201-0511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9745 AIRLINE HWY",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708168101",
            "telephone_number": "225-201-0511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COREY A. ROBERTSON, A PROFESSIONAL DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ROBERTSON",
        "authorized_official_first_name": "COREY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "225-201-0511",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "LA",
            "license": "4907",
            "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 Aug 22, 2020; 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.