NPIMap

Organization Active NPI

Duboue Dental LLC

Doing business as HDL Dental

  • Dental Clinic/Center
  • New Orleans, LA
National Provider Identifier
1336558311
Registry record updated Aug 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
5635 Issued in LA
Legal business name
DUBOUE DENTAL LLC
Doing business as
HDL Dental
Practice address
633 Carondelet St
New Orleans, LA 70130-3503
Phone
(504) 218-4444
Fax
(504) 218-4946
NPI assigned
Aug 4, 2014
Last updated
Aug 4, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2014

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

Authorized official

Name
Jaclyn Duboue, DDSNPI 1154409365
Title
President
Phone
(504) 390-2847

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
Dental Clinic/Center 261QD0000X 5635 LA Primary

Addresses

Primary practice location

633 Carondelet St
New Orleans, LA 70130-3503

Mailing address

PO Box 30458
New Orleans, LA 70190-0458
Phone (504) 218-4444

Other identifiers 1

IdentifierTypeStateIssuer
1856355MedicaidLA

Other names 1

  • HDL Dental Doing business as

National Provider Directory

National Provider Directory
Tax ID family
BR Dental Specialists LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

633 Carondelet St
New Orleans, LA 70130
Phone (504) 218-4444

Practitioners & affiliated clinicians

Practitioners 1

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": "1407110400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1407110400000",
    "number": "1336558311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 30458",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701900458",
            "telephone_number": "504-218-4444",
            "fax_number": "504-218-4946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "633 CARONDELET ST",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701303503",
            "telephone_number": "504-218-4444",
            "fax_number": "504-218-4946"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DUBOUE DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-04",
        "last_updated": "2014-08-04",
        "status": "A",
        "authorized_official_last_name": "DUBOUE",
        "authorized_official_first_name": "JACLYN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "504-390-2847",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "LA",
            "license": "5635",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1856355",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HDL Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in New Orleans, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2014; 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.