NPIMap

Organization Active NPI

Grand Canyon Mobile Dentistry

  • General Practice Dentistry
  • Baton Rouge, LA
National Provider Identifier
1205372893
Registry record updated Jan 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D009622 Issued in AZ
Legal business name
GRAND CANYON MOBILE DENTISTRY
Practice address
8480 Bluebonnet Blvd Ste E
Baton Rouge, LA 70810
Phone
(225) 767-4491
NPI assigned
Jan 6, 2017
Last updated
Jan 6, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2017

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

Authorized official

Name
Chad Biggio, D.D.S.NPI 1255598017
Title
Owner
Phone
(225) 767-4491

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
General Practice Dentistry 1223G0001X D009622 AZ Primary

Addresses

Primary practice location

8480 Bluebonnet Blvd Ste E
Baton Rouge, LA 70810

Mailing address

8480 Bluebonnet Blvd Ste E
Baton Rouge, LA 70810
Phone (225) 767-4491

National Provider Directory

National Provider Directory

Locations

8480 Bluebonnet Blvd
Ste E
Baton Rouge, LA 70810
Phone (225) 767-4491

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1483660800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1483660800000",
    "number": "1205372893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8480 BLUEBONNET BLVD STE E",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "70810",
            "telephone_number": "225-767-4491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8480 BLUEBONNET BLVD STE E",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "70810",
            "telephone_number": "225-767-4491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRAND CANYON MOBILE DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-06",
        "last_updated": "2017-01-06",
        "status": "A",
        "authorized_official_last_name": "BIGGIO",
        "authorized_official_first_name": "CHAD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "225-767-4491",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "D009622",
            "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 Jan 6, 2017; 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.