Nicole Renee' Boxberger, DDS
Individual provider Active NPI Pediatric Dentistry · New Orleans, LA
NPI 1376737866 · NPPES record last updated Feb 17, 2017
Key facts
- NPI
- 1376737866
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatric Dentistry 1223P0221X
- License
- 5908 (LA)
- Practice address
- 4061 Behrman Hwy
New Orleans, LA 70114 - Phone
- (504) 368-1990
- Fax
- (504) 366-2319
- NPI assigned
- Aug 28, 2007
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5908 | LA | MD | Professional Counselor |
| 2007014391 | MO | MD | Dentist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 5908 | LA | |
| Dentist | 122300000X | 2007014391 | MO | |
| Pediatric Dentistry | 1223P0221X | 5908 | LA | Yes |
Addresses
Primary practice location
4061 Behrman Hwy
New Orleans, LA 70114
Mailing address
4061 Behrman Hwy
New Orleans, LA 70114
Phone (504) 368-1990
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1859087 | Medicaid | LA |
Other providers in New Orleans, LA
- Brindisha A Bowman
- C'Onda Bowman
- Gerquel Bowman
- Jenna Adrienne Bowman
- Rachel Bowron
- Jessica Marie Boyce
- Bonnie A Boyd
- Isiah Gregory Boyd Sr.
- Lynette Boyd
- Paula August Boyd
All providers in New Orleans, LA · Pediatric Dentistry in Louisiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 17, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.