Dr. Michael Boudreaux DDS LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

DR. MICHAEL BOUDREAUX DDS LLC

Practice address

761 W Tunnel Blvd
Houma, LA 70360-5545

Phone

(985) 876-5430

NPI assigned

Oct 4, 2023

Organization subpart

No

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

Authorized official

Name

Mrs. Kayla Cyphers

Title

Office Manager

Phone

(985) 876-5430

Specialties & licenses 1

Addresses

Other names 1

• Southern Dental Group Doing business as

Locations

Practitioners 2

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

• Michael Joseph Boudreaux, D.D.S.

  • General Practice Dentistry
  • Houma, LA
  • NPI 1154583714
  NPD
• Kevin C Sanders, DMD

  • Dentist
  • Houma, LA
  • NPI 1881028934
  NPD (past)

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

{
    "created_epoch": "1696377600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696377600000",
    "number": "1336929595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "761 W TUNNEL BLVD",
            "city": "HOUMA",
            "state": "LA",
            "postal_code": "703605545",
            "telephone_number": "985-876-5430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "761 W TUNNEL BLVD",
            "city": "HOUMA",
            "state": "LA",
            "postal_code": "703605545",
            "telephone_number": "985-876-5430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. MICHAEL BOUDREAUX DDS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-04",
        "last_updated": "2023-10-04",
        "certification_date": "2023-10-04",
        "status": "A",
        "authorized_official_last_name": "CYPHERS",
        "authorized_official_first_name": "KAYLA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "985-876-5430",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southern Dental Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Dominique Kay Douglas
• Ja'Khi Douglas
• Jason Paul Douglas, PT
• Ryan E Dozar, NP-C
• Dr Frank Graffagnino, Apmc
• DRS Flynn Manceaux a Professional Chiropractic and Physical Therapy Co
• DRS Melancon Melancon & Theriot a Dental Corp
• Joseph Dubois, PT
• Beth V Duet, MSW, LCSW
• Katie Duet

• Dental Clinic/Center in Houma, LA
• Providers in Houma, 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 Oct 4, 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.