Raborn Dental Greenwell Springs LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

RABORN DENTAL GREENWELL SPRINGS LLC

Practice address

14127 Greenwell Springs Rd
Greenwell Springs, LA 70739-3305

Phone

(225) 460-2165

NPI assigned

Nov 27, 2023

Organization subpart

No

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

Authorized official

Name

Dr. Timothy Raborn, DDSNPI 1760422679

Title

Manager/ Member

Phone

(225) 405-4997

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Timothy Rhett Raborn, DDS

  • General Practice Dentistry
  • Baton Rouge, LA
  • NPI 1760422679
  NPD Authorized official

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

{
    "created_epoch": "1701043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701043200000",
    "number": "1699541003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7604 CLARET AVE",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708091584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14127 GREENWELL SPRINGS RD",
            "city": "GREENWELL SPRINGS",
            "state": "LA",
            "postal_code": "707393305",
            "telephone_number": "225-460-2165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RABORN DENTAL GREENWELL SPRINGS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-27",
        "last_updated": "2023-11-27",
        "certification_date": "2023-11-27",
        "status": "A",
        "authorized_official_last_name": "RABORN",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_title_or_position": "MANAGER/ MEMBER",
        "authorized_official_telephone_number": "225-405-4997",
        "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": []
}

• Personal Care Services - Waiver
• Pharmacy Central LLC
• Physicians Home Care Organization LLC
• Physicians Home Care Services, LLC
• David Kevin Prudhome, DDS
• Lucy Elizabeth Raborn, DDS
• Kyran Nathaniel Reid
• Tracey K Reily, PA-C
• Alex C Robertson, MD
• Tahshawnda Robins, CCC-SLP

• Dental Clinic/Center in Greenwell Springs, LA
• Providers in Greenwell Springs, 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 Nov 27, 2023; 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.