Premier Mobile Dentistry of VA LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

PREMIER MOBILE DENTISTRY OF VA LLC

Practice address

6224 Province LN
Baton Rouge, LA 70808-3574

Phone

(225) 324-5945

Fax

(225) 752-0196

NPI assigned

Apr 11, 2018

Organization subpart

No

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

Authorized official

Name

Dr. Michael Nuss Rabel, DDS

Title

Owner

Phone

(225) 776-0006

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1523404800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1523404800000",
    "number": "1689171076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6224 PROVINCE LN",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708083574",
            "telephone_number": "122-532-4594",
            "fax_number": "225-752-0196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6224 PROVINCE LN",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708083574",
            "telephone_number": "225-324-5945",
            "fax_number": "225-752-0196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER MOBILE DENTISTRY OF VA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-11",
        "last_updated": "2018-04-11",
        "status": "A",
        "authorized_official_last_name": "RABEL",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "NUSS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "225-776-0006",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Premier Servicese of Louisiana
• Premium United Care

• Dental Clinic/Center in Baton Rouge, LA
• Providers in Baton Rouge, LA by specialty
• Dental Clinic/Center in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2018; 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.