Vintage Leigh Leblanc, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

5523 Issued in LA

Practice address

1144 Coolidge Blvd Ste a
Lafayette, LA 70503

Phone

(337) 234-8788

Fax

(337) 256-5150

NPI assigned

Dec 14, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Vintage Leigh Delahoussaye Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Vintage L Delahoussaye DDS Apdc

  • Dental Clinic/Center
  • Lafayette, LA
  • NPI 1407364730
  NPD Authorized official

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

{
    "created_epoch": "1166054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681862400000",
    "number": "1336201417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 REGENCY SQ",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705084221",
            "telephone_number": "337-739-3396",
            "fax_number": "337-234-8723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1144 COOLIDGE BLVD STE A",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "70503",
            "telephone_number": "337-234-8788",
            "fax_number": "337-256-5150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEBLANC",
        "first_name": "VINTAGE",
        "middle_name": "LEIGH",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-14",
        "last_updated": "2023-04-19",
        "certification_date": "2023-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "LA",
            "license": "5523",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VINTAGE",
            "last_name": "DELAHOUSSAYE",
            "middle_name": "LEIGH",
            "prefix": "DR.",
            "credential": "DDS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Nina Rachelle Leblanc, PA-C
• Richard Jude Leblanc, RN,MN
• Robert D Leblanc, MD
• Selleck Leblanc
• Troy J Leblanc, D.C.
• Paul Scott Lebleu, DDS
• Scott Lebleu, LPC
• Lainie Leblue
• Brittany Leboeuf
• Christian Leboeuf, BSN, MSN, PMHNP-BC

• General Practice Dentistry in Lafayette, LA
• Providers in Lafayette, LA by specialty
• General Practice Dentistry in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2023; 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.