NPIMap

Organization Active NPI

Central Dental Care

  • General Practice Dentistry
  • Baton Rouge, LA
National Provider Identifier
1609934488
Registry record updated Jul 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
5406 Issued in LA
Legal business name
CENTRAL DENTAL CARE
Practice address
11424 Sullivan Rd BLDG B Suite a
Baton Rouge, LA 70818-3615
Phone
(225) 261-6645
Fax
(225) 262-9061
NPI assigned
Dec 5, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2008

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

Authorized official

Name
Jacob F Henderson, D.D.S.
Title
Owner
Phone
(225) 261-6645

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 5406 LA Primary

Addresses

Primary practice location

11424 Sullivan Rd BLDG B Suite a
Baton Rouge, LA 70818-3615

Mailing address

11424 Sullivan Road BLDG B Suite a
Baton Rouge, LA 70818
Phone (225) 261-6645

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215993600000",
    "number": "1609934488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11424 SULLIVAN ROAD BLDG B SUITE A",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "70818",
            "telephone_number": "225-261-6645",
            "fax_number": "225-262-9061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11424 SULLIVAN RD BLDG B SUITE A",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708183615",
            "telephone_number": "225-261-6645",
            "fax_number": "225-262-9061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL DENTAL CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-05",
        "last_updated": "2008-07-14",
        "status": "A",
        "authorized_official_last_name": "HENDERSON",
        "authorized_official_first_name": "JACOB",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "225-261-6645",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "LA",
            "license": "5406",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jul 14, 2008; 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.