NPIMap

Organization Active NPI

Distinctive Smiles of Baton Rouge, LLC

  • General Practice Dentistry
  • Baton Rouge, LA
National Provider Identifier
1467577130
Registry record updated Dec 9, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
5131 Issued in LA
Legal business name
DISTINCTIVE SMILES OF BATON ROUGE, LLC
Practice address
8894 Airline Hwy
Suite M
Baton Rouge, LA 70815-4081
Phone
(225) 218-9218
Fax
(225) 218-9219
NPI assigned
Mar 20, 2007
Last updated
Dec 9, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2009

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

Authorized official

Name
Dr. Sancerie J O'Rourke -AllenNPI 1962420836
Title
President
Phone
(225) 218-9218

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
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 5131 LA Primary

Addresses

Primary practice location

8894 Airline Hwy
Suite M
Baton Rouge, LA 70815-4081

Mailing address

8894 Airline Hwy
Suite M
Baton Rouge, LA 70815-4081
Phone (225) 218-9218

Other identifiers 1

IdentifierTypeStateIssuer
1851311MedicaidLA

National Provider Directory

National Provider Directory

Locations

8894 Airline Hwy
Ste M
Baton Rouge, LA 70815
Phone (225) 218-9218

Practitioners & affiliated clinicians

Practitioners 5

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": "1174348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1260316800000",
    "number": "1467577130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8894 AIRLINE HWY",
            "address_2": "SUITE M",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708154081",
            "telephone_number": "225-218-9218",
            "fax_number": "225-218-9219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8894 AIRLINE HWY",
            "address_2": "SUITE M",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708154081",
            "telephone_number": "225-218-9218",
            "fax_number": "225-218-9219"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DISTINCTIVE SMILES OF BATON ROUGE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-20",
        "last_updated": "2009-12-09",
        "status": "A",
        "authorized_official_last_name": "O'ROURKE -ALLEN",
        "authorized_official_first_name": "SANCERIE",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "225-218-9218",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "LA",
            "license": "5131",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1851311",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baton Rouge, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2009; 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.