Organization Active NPI

Renaissance Dental Implant Center, LLC

  • Dentist
  • Metairie, LA
National Provider Identifier
1639976491
Registry record updated Mar 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
RENAISSANCE DENTAL IMPLANT CENTER, LLC
Practice address
3131 Veterans Blvd.
Metairie, LA 70002
Phone
(504) 609-2599
Fax
(504) 386-4956
NPI assigned
Feb 28, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2025

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

Authorized official

Name
Mrs. Samantha Coats
Title
Credentialing Specialist
Phone
(504) 609-2599

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

3131 Veterans Blvd.
Metairie, LA 70002

Mailing address

3131 Veterans Blvd.
Metairie, LA 70002
Phone (504) 609-2599

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1740700800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741564800000",
    "number": "1639976491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3131 VETERANS BLVD.",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "70002",
            "telephone_number": "504-609-2599",
            "fax_number": "504-386-4956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3131 VETERANS BLVD.",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "70002",
            "telephone_number": "504-609-2599",
            "fax_number": "504-386-4956"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENAISSANCE DENTAL IMPLANT CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-02-28",
        "last_updated": "2025-03-10",
        "certification_date": "2025-03-10",
        "status": "A",
        "authorized_official_last_name": "COATS",
        "authorized_official_first_name": "SAMANTHA",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "504-609-2599",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Metairie, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2025; 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.