Rae a. Gauthier, DDS, LLC Dba Ponchatoula Family Dentistry

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

5909 Issued in LA

Legal business name

RAE A. GAUTHIER, DDS, LLC DBA PONCHATOULA FAMILY DENTISTRY

Practice address

430 E Pine St
Ponchatoula, LA 70454-2544

Phone

(985) 687-3806

Fax

(985) 386-8467

NPI assigned

Sep 29, 2017

Organization subpart

No

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

Authorized official

Name

Rae Ann Gauthier, DDS

Title

Owner/Dentist

Phone

(985) 386-8454

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

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

• Douglas M George, DDS

  • General Practice Dentistry
  • Ponchatoula, LA
  • NPI 1750879854
  NPD

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

{
    "created_epoch": "1506643200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1215446521",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "430 E PINE ST",
            "city": "PONCHATOULA",
            "state": "LA",
            "postal_code": "704542544",
            "telephone_number": "985-687-3806",
            "fax_number": "985-386-8467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 E PINE ST",
            "city": "PONCHATOULA",
            "state": "LA",
            "postal_code": "704542544",
            "telephone_number": "985-687-3806",
            "fax_number": "985-386-8467"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAE A. GAUTHIER, DDS, LLC DBA PONCHATOULA FAMILY DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-29",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "GAUTHIER",
        "authorized_official_first_name": "RAE",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "985-386-8454",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "LA",
            "license": "5909",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1859095",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amber Poole Puma, RDN, LDN
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• Chessa Dawn Purser, DC
• Quality Home Oxygen, Inc.
• Lucas Quebedeaux
• Ashlyn Kay Reese
• Rene Drive Community Home
• Rescare, Inc.
• Right on-Time Delivery Service LLC
• Mia Robertson

• Dental Clinic/Center in Ponchatoula, LA
• Providers in Ponchatoula, LA by specialty
• Dental Clinic/Center in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.