Colbert Family Dental, LLC

Primary specialty

DentistTaxonomy code 122300000X

License

5321 Issued in LA

Legal business name

COLBERT FAMILY DENTAL, LLC

Practice address

1006 Surrey St
Lafayette, LA 70501-6143

Phone

(337) 234-0411

NPI assigned

Mar 19, 2007

Organization subpart

No

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

Authorized official

Name

Tahisa ColbertNPI 1245304187

Title

Dentist

Phone

(337) 234-0411

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

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

• Tahisa Patric Colbert, D.D.S.

  • Dentist
  • Lafayette, LA
  • NPI 1245304187
  NPD (past) Authorized official

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

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1356465934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1006 SURREY ST",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705016143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1006 SURREY ST",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705016143",
            "telephone_number": "337-234-0411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLBERT FAMILY DENTAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "COLBERT",
        "authorized_official_first_name": "TAHISA",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "337-234-0411"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "LA",
            "license": "5321",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1881821",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Monique Cohen, PMHNP-BC
• Cohn Chiropractic Clinics
• Jeffrey Mitchell Cohn, D.C.
• Col Management LLC
• Lakesha Marie Colar
• Elaine Marie Colbert, APRN
• Tahisa Patric Colbert, D.D.S.
• Danielle Cole-Thomas, LPC
• Jimmie D Cole, PH.D.
• Megan Cole

• Dentist in Lafayette, LA
• Providers in Lafayette, LA by specialty
• Dentist in Louisiana

• 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.