J Eric Lavespere DDS LLC

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

4708 Issued in LA

Legal business name

J ERIC LAVESPERE DDS LLC

Practice address

2005 Forsythe Ave
Monroe, LA 71201

Phone

(318) 388-2630

Fax

(318) 322-4537

NPI assigned

May 14, 2008

Last updated

May 14, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Lila C Waliman

Title

Bookkeeper Secretary

Phone

(318) 388-2630

Specialties & licenses 1

Addresses

Other names 1

• Damon G Bradford DDS Ltd Former legal business name

Locations

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

{
    "created_epoch": "1210723200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210723200000",
    "number": "1699942060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2005 FORSYTHE AVE",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "71201",
            "telephone_number": "318-388-2630",
            "fax_number": "318-322-4537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2005 FORSYTHE AVE",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "71201",
            "telephone_number": "318-388-2630",
            "fax_number": "318-322-4537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "J ERIC LAVESPERE DDS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-14",
        "last_updated": "2008-05-14",
        "status": "A",
        "authorized_official_last_name": "WALIMAN",
        "authorized_official_first_name": "LILA",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "BOOKKEEPER SECRETARY",
        "authorized_official_telephone_number": "318-388-2630",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "LA",
            "license": "4708",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Damon G Bradford DDS Ltd",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Beverly Jackson

• Periodontics in Monroe, LA
• Providers in Monroe, LA by specialty
• Periodontics in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2008; 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.