Peach Tree Dental West Monroe, LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

PEACH TREE DENTAL WEST MONROE, LLC

Practice address

3422 Cypress St
West Monroe, LA 71291-7310

Phone

(318) 381-9340

NPI assigned

Jan 6, 2020

Organization subpart

No

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

Authorized official

Name

Joni Porter

Title

Coo

Phone

(318) 381-9340

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1578268800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1578268800000",
    "number": "1699314799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3422 CYPRESS ST",
            "city": "WEST MONROE",
            "state": "LA",
            "postal_code": "712917310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3422 CYPRESS ST",
            "city": "WEST MONROE",
            "state": "LA",
            "postal_code": "712917310",
            "telephone_number": "318-381-9340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEACH TREE DENTAL WEST MONROE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-06",
        "last_updated": "2020-01-06",
        "certification_date": "2020-01-06",
        "status": "A",
        "authorized_official_last_name": "PORTER",
        "authorized_official_first_name": "JONI",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "318-381-9340"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Cherry M. Patton, NP
• Peaceful Hearts Counseling, LLC
• Nathan Edward Pearson, FNP
• Pediatric Clinic of West Monroe
• Pegasus Primary Providers, LLC
• Dawn W Pennebaker, M.D.
• Kenyatta Percy

• Dental Clinic/Center in West Monroe, LA
• Providers in West Monroe, 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 Jan 6, 2020; 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.