NPIMap

Organization Active NPI

Exceptional Dental of Metairie, LLC

  • General Practice Dentistry
  • Metairie, LA
National Provider Identifier
1326575945
Registry record updated Apr 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
5312 Issued in LA
Legal business name
EXCEPTIONAL DENTAL OF METAIRIE, LLC
Practice address
1128 Clearview Pkwy
Metairie, LA 70001-3418
Phone
(504) 900-1195
NPI assigned
May 13, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2025

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

Authorized official

Name
Darrell BourgNPI 1215053558
Title
Owner
Phone
(504) 232-6624

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 DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 5312 LA Primary

Addresses

Primary practice location

1128 Clearview Pkwy
Metairie, LA 70001-3418

Mailing address

1128 Clearview Pkwy
Metairie, LA 70001-3418

National Provider Directory

National Provider Directory

Locations

1128 Clearview Pkwy
Metairie, LA 70001
Phone (504) 733-1135

Practitioners & affiliated clinicians

Practitioners 4

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

NPI Registry JSON

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

{
    "created_epoch": "1494633600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1743984000000",
    "number": "1326575945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1128 CLEARVIEW PKWY",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700013418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1128 CLEARVIEW PKWY",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700013418",
            "telephone_number": "504-900-1195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXCEPTIONAL DENTAL OF METAIRIE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-13",
        "last_updated": "2025-04-07",
        "certification_date": "2025-04-07",
        "status": "A",
        "authorized_official_last_name": "BOURG",
        "authorized_official_first_name": "DARRELL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "504-232-6624"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "LA",
            "license": "5312",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Metairie, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2025; 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.