NPIMap

Organization Active NPI

Chedly Vincent DMD a Professional Corporation

  • General Practice Dentistry
  • Baton Rouge, LA
National Provider Identifier
1194267567
Registry record updated Nov 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
6631 Issued in LA
Legal business name
CHEDLY VINCENT DMD A PROFESSIONAL CORPORATION
Practice address
12730 Millerville Greens Blvd
Suite 1
Baton Rouge, LA 70816
Phone
(225) 234-0713
NPI assigned
Nov 16, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2016

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

Authorized official

Name
Chedly Vincent, DMD
Title
Owner
Phone
(225) 234-0713

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 6631 LA Primary

Addresses

Primary practice location

12730 Millerville Greens Blvd
Suite 1
Baton Rouge, LA 70816

Mailing address

PO Box 3189
Syracuse, NY 13220-3189
Phone (315) 454-6000

Other names 1

  • Aspen Dental Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1479254400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1479254400000",
    "number": "1194267567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3189",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132203189",
            "telephone_number": "315-454-6000",
            "fax_number": "315-410-5531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12730 MILLERVILLE GREENS BLVD",
            "address_2": "SUITE 1",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "70816",
            "telephone_number": "225-234-0713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHEDLY VINCENT DMD A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-16",
        "last_updated": "2016-11-16",
        "status": "A",
        "authorized_official_last_name": "VINCENT",
        "authorized_official_first_name": "CHEDLY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "225-234-0713",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "LA",
            "license": "6631",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Aspen 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 Nov 16, 2016; 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.