NPIMap

Organization Active NPI

Susanne O. Core DMD PDC Family Dentistry

  • Dentist
  • Covington, LA
National Provider Identifier
1366725582
Registry record updated Jun 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2392 Issued in MS
Legal business name
SUSANNE O. CORE DMD PDC FAMILY DENTISTRY
Practice address
73193 Hwy 25
Covington, LA 70435
Phone
(985) 630-6906
Fax
(985) 796-5315
NPI assigned
Sep 23, 2011
Last updated
Jun 23, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2016

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

Authorized official

Name
Susanne O. Core, DMDNPI 1609950518
Title
Owner
Phone
(985) 630-6906

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2392 MS Primary
Dentist 122300000X 3600 MS

Addresses

Primary practice location

73193 Hwy 25
Covington, LA 70435

Mailing address

73193 Hwy 25
Covington, LA 70435
Phone (985) 630-6906

National Provider Directory

National Provider Directory
Tax ID family
Collins Blvd Family Dentistry2 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

73193 Highway 25
Covington, LA 70435
Phone (985) 630-6906

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": "1316736000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1466640000000",
    "number": "1366725582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "73193 HWY 25",
            "city": "COVINGTON",
            "state": "LA",
            "postal_code": "70435",
            "telephone_number": "985-630-6906",
            "fax_number": "985-796-5315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "73193 HWY 25",
            "city": "COVINGTON",
            "state": "LA",
            "postal_code": "70435",
            "telephone_number": "985-630-6906",
            "fax_number": "985-796-5315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUSANNE O. CORE DMD PDC FAMILY DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-23",
        "last_updated": "2016-06-23",
        "status": "A",
        "authorized_official_last_name": "CORE",
        "authorized_official_first_name": "SUSANNE",
        "authorized_official_middle_name": "O.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "985-630-6906",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MS",
            "license": "2392",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MS",
            "license": "3600",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Covington, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2016; 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.