NPIMap

Organization Active NPI

Vintage L Delahoussaye DDS Apdc

  • Dental Clinic/Center
  • Lafayette, LA
National Provider Identifier
1407364730
Registry record updated Apr 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
5523 Issued in LA
Legal business name
VINTAGE L DELAHOUSSAYE DDS APDC
Practice address
1144 Coolidge Blvd Ste a
Lafayette, LA 70503-2622
Phone
(337) 234-8788
NPI assigned
Jan 22, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2023

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

Authorized official

Name
Vintage Leblanc, DDSNPI 1336201417
Title
Owner/President
Phone
(337) 234-8788

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 5523 LA Primary

Addresses

Primary practice location

1144 Coolidge Blvd Ste a
Lafayette, LA 70503-2622

Mailing address

107 Regency SQ
Lafayette, LA 70508-4221
Phone (337) 739-3396

National Provider Directory

National Provider Directory

Locations

1144 Coolidge Blvd
Ste A
Lafayette, LA 70503
Phone (337) 234-8788

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1516579200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1681862400000",
    "number": "1407364730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 REGENCY SQ",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705084221",
            "telephone_number": "337-739-3396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1144 COOLIDGE BLVD STE A",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705032622",
            "telephone_number": "337-234-8788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VINTAGE L DELAHOUSSAYE DDS APDC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-22",
        "last_updated": "2023-04-19",
        "certification_date": "2023-04-19",
        "status": "A",
        "authorized_official_last_name": "LEBLANC",
        "authorized_official_first_name": "VINTAGE",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "337-234-8788",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "LA",
            "license": "5523",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 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.