Kaede Jacob Collette, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

7585 Issued in LA

Practice address

10522 S Glenstone PL
Baton Rouge, LA 70810-2875

Phone

(225) 769-5377

NPI assigned

Jun 26, 2024

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

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Smilestars, LLC

  • Pediatric Dentistry
  • Baton Rouge, LA
  • NPI 1093879322
  NPD (past)

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

{
    "created_epoch": "1719360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719360000000",
    "number": "1487499182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10522 S GLENSTONE PL",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708102875",
            "telephone_number": "225-769-5377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10522 S GLENSTONE PL",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708102875",
            "telephone_number": "225-769-5377"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15097 Highway 73",
            "address_purpose": "LOCATION",
            "city": "Prairieville",
            "state": "LA",
            "postal_code": "707693504",
            "country_code": "US",
            "telephone_number": "225-313-4245",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COLLETTE",
        "first_name": "KAEDE",
        "middle_name": "JACOB",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-06-26",
        "last_updated": "2024-06-26",
        "certification_date": "2024-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "LA",
            "license": "7585",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Collaborative Minds, LLC
• Kennedy Beauchamp Colle
• College Family Dentistry, LLC
• Collegiate Baton Rouge
• William H Collett, LCSW
• Rose L Colley, LCSW
• Braelyn Collier
• Briclyn Shernae Collier
• Karen Lee Collier, M.A., M.S.W., M.H.A.
• Lauren Christine Collier, MOT, LOTR

• General Practice Dentistry in Baton Rouge, LA
• Providers in Baton Rouge, 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 Jun 26, 2024; 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.