NPIMap

Organization Active NPI

Dental Health of Marrero, Iinc.

  • General Practice Dentistry
  • Harvey, LA
National Provider Identifier
1508902834
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2789 Issued in LA
Legal business name
DENTAL HEALTH OF MARRERO, IINC.
Practice address
4001 Lapalco Blvd
Suite 10
Harvey, LA 70058-2389
Phone
(504) 340-0076
Fax
(504) 340-0078
NPI assigned
Jan 30, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Nolan H Boudreaux, D.D.S.
Title
Dentist
Phone
(504) 340-0076

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 2789 LA Primary

Addresses

Primary practice location

4001 Lapalco Blvd
Suite 10
Harvey, LA 70058-2389

Mailing address

4001 Lapalco Blvd
Suite 10
Harvey, LA 70058-2389
Phone (504) 340-0076

National Provider Directory

National Provider Directory

Locations

4001 Lapalco Blvd
Ste 10
Harvey, LA 70058
Phone (504) 340-0076

Practitioners & affiliated clinicians

Practitioners 1

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": "1170115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1508902834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4001 LAPALCO BLVD",
            "address_2": "SUITE 10",
            "city": "HARVEY",
            "state": "LA",
            "postal_code": "700582389",
            "telephone_number": "504-340-0076",
            "fax_number": "504-340-0078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4001 LAPALCO BLVD",
            "address_2": "SUITE 10",
            "city": "HARVEY",
            "state": "LA",
            "postal_code": "700582389",
            "telephone_number": "504-340-0076",
            "fax_number": "504-340-0078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL HEALTH OF MARRERO, IINC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BOUDREAUX",
        "authorized_official_first_name": "NOLAN",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "504-340-0076",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "LA",
            "license": "2789",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Harvey, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.