Organization Active NPI

Edward L. Donaldson, Jr.,DDS Apdc and Jill M Donaldson, DDS Apdc

  • Pediatric Dentistry
  • Slidell, LA
National Provider Identifier
1245445915
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
Legal business name
EDWARD L. DONALDSON, JR.,DDS APDC AND JILL M DONALDSON, DDS APDC
Practice address
2960 Gause Blvd E
Slidell, LA 70461-4153
Phone
(985) 641-3988
Fax
(985) 646-2536
NPI assigned
May 14, 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. Edward Lawrence Donaldson Jr., DDS
Title
Partner
Phone
(985) 641-3988

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X Primary

Addresses

Primary practice location

2960 Gause Blvd E
Slidell, LA 70461-4153

Mailing address

2960 Gause Blvd E
Slidell, LA 70461-4153
Phone (985) 641-3988

Other identifiers 1

IdentifierTypeStateIssuer
1880191MedicaidLA

National Provider Directory

National Provider Directory

Locations

2935 Highway 190
Mandeville, LA 70471
Phone (985) 727-7030

2960 Gause Blvd E
Slidell, LA 70461
Phone (985) 641-3988

59070 Amber St
Slidell, LA 70461
Phone (985) 641-3245

NPI Registry JSON

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

{
    "created_epoch": "1179100800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1245445915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2960 GAUSE BLVD E",
            "city": "SLIDELL",
            "state": "LA",
            "postal_code": "704614153",
            "telephone_number": "985-641-3988",
            "fax_number": "985-646-2536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2960 GAUSE BLVD E",
            "city": "SLIDELL",
            "state": "LA",
            "postal_code": "704614153",
            "telephone_number": "985-641-3988",
            "fax_number": "985-646-2536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDWARD L. DONALDSON, JR.,DDS APDC AND JILL M DONALDSON, DDS APDC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DONALDSON",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "LAWRENCE",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "985-641-3988",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1880191",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Slidell, 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.