Charles Austin Boudreaux, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

LA.4049 Issued in LA

Practice address

5589 Canal Blvd
New Orleans, LA 70124-2745

Phone

(504) 482-3303

Fax

(504) 467-9497

NPI assigned

Oct 16, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1427138502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5589 CANAL BLVD",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701242745",
            "telephone_number": "504-482-3303",
            "fax_number": "504-467-9497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5589 CANAL BLVD",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701242745",
            "telephone_number": "504-482-3303",
            "fax_number": "504-467-9497"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUDREAUX",
        "first_name": "CHARLES",
        "middle_name": "AUSTIN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "LA",
            "license": "LA.4049",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Allison Boudreau
• Abigail Hagen Boudreaux
• Adair Elizabeth Boudreaux
• Alice S Boudreaux, CRNA
• Bridget A Boudreaux, MD
• David Michael Boudreaux, CRNA
• Jenesha Michelle Boudreaux
• Jessica Marie Boudreaux, D.O.
• Kimberly Erica Boudreaux, PA-C
• Kristi Boudreaux, M.D.

• General Practice Dentistry in New Orleans, LA
• Providers in New Orleans, LA by specialty
• General Practice Dentistry in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.