NPIMap

Organization Active NPI

Jacob Dent, DDS Lafayette Modern Dentistry, a Professional Corporation

Doing business as Lafayette Modern Dentistry

  • Dentist
  • Lafayette, LA
National Provider Identifier
1538530381
Registry record updated Oct 19, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
JACOB DENT, DDS LAFAYETTE MODERN DENTISTRY, A PROFESSIONAL CORPORATION
Doing business as
Lafayette Modern Dentistry
Practice address
4243 Ambassador Caffery Pkwy, Ste 118
Lafayette, LA 70508
Phone
(337) 422-3587
Fax
(337) 214-1675
NPI assigned
Oct 19, 2015
Last updated
Oct 19, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2015

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

Authorized official

Name
Dr. Jacob Dent, DDS
Title
Onwer Doctor
Phone
(337) 422-3587

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X NU Primary

Addresses

Primary practice location

4243 Ambassador Caffery Pkwy, Ste 118
Lafayette, LA 70508

Mailing address

17000 Red Hill Avenue
Irvine, CA 92614
Phone (714) 845-8890

Other names 1

  • Lafayette Modern Dentistry Doing business as

National Provider Directory

National Provider Directory

Locations

4243 Ambassador Caffery Pkwy
Ste 118
Lafayette, LA 70508
Phone (337) 422-3587

Practitioners & affiliated clinicians

Practitioners 8

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": "1445212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1445212800000",
    "number": "1538530381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17000 RED HILL AVENUE",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "92614",
            "telephone_number": "714-845-8890",
            "fax_number": "949-474-1495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4243 AMBASSADOR CAFFERY PKWY, STE 118",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "70508",
            "telephone_number": "337-422-3587",
            "fax_number": "337-214-1675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACOB DENT, DDS LAFAYETTE MODERN DENTISTRY, A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-19",
        "last_updated": "2015-10-19",
        "status": "A",
        "authorized_official_last_name": "DENT",
        "authorized_official_first_name": "JACOB",
        "authorized_official_title_or_position": "ONWER DOCTOR",
        "authorized_official_telephone_number": "337-422-3587",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lafayette Modern Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Oct 19, 2015; 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.