Leroy Joseph Boudreaux, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2267 Issued in LA

Practice address

209 Iberville St
Donaldsonville, LA 70346-2419

Phone

(225) 473-9808

Fax

(225) 473-3701

NPI assigned

Feb 14, 2009

Last updated

Feb 14, 2009By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1234569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1234569600000",
    "number": "1659510675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 IBERVILLE ST",
            "city": "DONALDSONVILLE",
            "state": "LA",
            "postal_code": "703462419",
            "telephone_number": "225-473-9808",
            "fax_number": "225-473-3701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 IBERVILLE ST",
            "city": "DONALDSONVILLE",
            "state": "LA",
            "postal_code": "703462419",
            "telephone_number": "225-473-9808",
            "fax_number": "225-473-3701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUDREAUX",
        "first_name": "LEROY",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-02-14",
        "last_updated": "2009-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "LA",
            "license": "2267",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lynn James Becnel
• Cami Julien Birtha
• Katelyn Blanchard
• Baige Lipoma Boudreaux, MS, L-SLP, CCC-SLP
• Lacy Millet Boudreaux, NP
• Stephanie Bourg, L-SLP, CCC-SLP
• Charles Bourgeois
• Edward August Brauwn, DC
• Victoria Brown, MSW
• Amanda Chapman Bullman, M.A., CCC-SLP

• General Practice Dentistry in Donaldsonville, LA
• Providers in Donaldsonville, LA by specialty
• General Practice Dentistry in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2009; 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.