Kent Raymond Mauduit, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

3719 Issued in LA

Practice address

429 W Airline Hwy Ste F
La Place, LA 70068-3817

Phone

(985) 652-3121

Fax

(985) 651-0701

NPI assigned

Jul 18, 2006

Last updated

Sep 27, 2010By 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

Enrolled in LA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285545600000",
    "number": "1700804473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 BELLE GROVE DR",
            "city": "LA PLACE",
            "state": "LA",
            "postal_code": "700685905",
            "telephone_number": "985-652-4379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "429 W AIRLINE HWY STE F",
            "city": "LA PLACE",
            "state": "LA",
            "postal_code": "700683817",
            "telephone_number": "985-652-3121",
            "fax_number": "985-651-0701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAUDUIT",
        "first_name": "KENT",
        "middle_name": "RAYMOND",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2010-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "LA",
            "license": "3719",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Devin Mason Sr., MA
• Michele Allen Mason
• Taquana Zeno Mason, LPN
• Keynika Trenell Mathieu
• Sharon Stakelum Matranga, LCSW
• Craig W. Maumus, M.D.
• Leslye McAllister-Young
• Rebekah D'Angelo McAllister, MA, RD, LDN
• Whitley McCoy
• Rochelle McGee

• General Practice Dentistry in La Place, LA
• Providers in La Place, 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 Sep 27, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.