NPIMap

Organization Active NPI

Louisiana Dental Professionals, Donovan Dronet, DDS, a Professional de

Doing business as Magnolia Family Dentistry

  • General Practice Dentistry
  • Lafayette, LA
National Provider Identifier
1558768978
Registry record updated Oct 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
LOUISIANA DENTAL PROFESSIONALS, DONOVAN DRONET, DDS, A PROFESSIONAL DE
Doing business as
Magnolia Family Dentistry
Practice address
204 Crescent Ranch Blvd
Lafayette, LA 70508-7530
Phone
(337) 233-1566
NPI assigned
Dec 1, 2014
Last updated
Oct 14, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
LOUISIANA DENTAL PROFESSIONALS, DONOVAN DRONET, DDS, A PROFESSIONAL DEAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 14, 2021

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

Authorized official

Name
Kendra Walker
Title
Credentialing Supervisor
Phone
(217) 540-8312

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X NU Primary

Addresses

Primary practice location

204 Crescent Ranch Blvd
Lafayette, LA 70508-7530

Mailing address

204 Crescent Ranch Blvd
Lafayette, LA 70508-7530

Other names 1

  • Magnolia Family Dentistry Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Louisiana Dental Professionals Dr Jamini Mwendo DDS a Professio16 organizations share this tax ID, including this one
Part of
Louisiana Dental Professionals Dr Jamini Mwendo DDS a Professio

Other organizations with this tax ID 15

Organizations that report the same tax identification number in the National Provider Directory.

View all 15

Locations

204 Crescent Ranch Blvd
Lafayette, LA 70508
Phone (337) 233-1566

4906 Ambassador Caffery Pkwy
Lafayette, LA 70508
Phone (337) 235-8560

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1417392000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1634169600000",
    "number": "1558768978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 CRESCENT RANCH BLVD",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705087530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 CRESCENT RANCH BLVD",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705087530",
            "telephone_number": "337-233-1566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOUISIANA DENTAL PROFESSIONALS, DONOVAN DRONET, DDS, A PROFESSIONAL DE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LOUISIANA DENTAL PROFESSIONALS, DONOVAN DRONET, DDS, A PROFESSIONAL DE",
        "enumeration_date": "2014-12-01",
        "last_updated": "2021-10-14",
        "certification_date": "2021-10-14",
        "status": "A",
        "authorized_official_last_name": "WALKER",
        "authorized_official_first_name": "KENDRA",
        "authorized_official_title_or_position": "CREDENTIALING SUPERVISOR",
        "authorized_official_telephone_number": "217-540-8312"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Magnolia Family 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 14, 2021; 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.