Active NPI
Sally B. Daly DDS LLC
Doing business as Fleur de Lis Mobile Dental
- Dental Clinic/Center
- Baton Rouge, LA
National Provider Identifier
1174993661
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Clinic/Center
- License
- 4860
- Legal business name
- SALLY B. DALY DDS LLC
- Doing business as
- Fleur de Lis Mobile Dental
- Practice address
- 10713 N Oak Hills Pkwy
Suite B
Baton Rouge, LA 70810-2967 - Phone
- (225) 767-5343
- NPI assigned
- Sep 28, 2015
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Sally Bowie Daly, DDS
- Title
- Owner
- Phone
- (225) 767-5343
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Clinic/Center | 261QD0000X | 4860 | LA | Primary |
Addresses
Primary practice location
10713 N Oak Hills Pkwy
Suite B
Baton Rouge, LA 70810-2967
Mailing address
PO Box 82380
Baton Rouge, LA 70884-2380
Phone (225) 767-5343
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1848603 | Medicaid | LA | |
| 2959 | Other | LA | MCNA |
Other names 1
- Fleur de Lis Mobile Dental
National Provider Directory
National Provider Directory- Tax ID family
- Fleur de Lis Mobile Dental
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1443398400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1443398400000",
"number": "1174993661",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 82380",
"city": "BATON ROUGE",
"state": "LA",
"postal_code": "708842380",
"telephone_number": "225-767-5343"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10713 N OAK HILLS PKWY",
"address_2": "SUITE B",
"city": "BATON ROUGE",
"state": "LA",
"postal_code": "708102967",
"telephone_number": "225-767-5343"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SALLY B. DALY DDS LLC",
"organizational_subpart": "NO",
"enumeration_date": "2015-09-28",
"last_updated": "2015-09-28",
"status": "A",
"authorized_official_last_name": "DALY",
"authorized_official_first_name": "SALLY",
"authorized_official_middle_name": "BOWIE",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "225-767-5343",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "DDS"
},
"taxonomies": [
{
"code": "261QD0000X",
"taxonomy_group": "",
"desc": "Clinic/Center, Dental",
"state": "LA",
"license": "4860",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1848603",
"state": "LA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MCNA",
"identifier": "2959",
"state": "LA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Fleur de Lis Mobile Dental",
"code": "3",
"type": "Doing Business As"
}
]
}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 Sep 28, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.