Organization Active NPI

Anthony Indovina a P D C

  • Oral and Maxillofacial Surgery (Dentist)
  • Marrero, LA
National Provider Identifier
1801192836
Registry record updated Feb 9, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
2650 Issued in LA
Legal business name
ANTHONY INDOVINA A P D C
Practice address
5132 Lapalco Blvd
2ND Floor
Marrero, LA 70072-4268
Phone
(504) 340-2401
Fax
(504) 340-2423
NPI assigned
Feb 9, 2011
Last updated
Feb 9, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2011

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

Authorized official

Name
Dr. Anthony A. Indovina Sr., D.D.S.NPI 1184787921
Title
Owner/President
Phone
(504) 340-2401

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 2650 LA Primary

Addresses

Primary practice location

5132 Lapalco Blvd
2ND Floor
Marrero, LA 70072-4268

Mailing address

5132 Lapalco Blvd
2ND Floor
Marrero, LA 70072-4268
Phone (504) 340-2401

Other identifiers 2

IdentifierTypeStateIssuer
600034OtherLAUNITED CONCORDIA
1826502MedicaidLA

National Provider Directory

National Provider Directory

Locations

5132 Lapalco Blvd
Ste 2
Marrero, LA 70072
Phone (504) 340-2401

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1297209600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1297209600000",
    "number": "1801192836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5132 LAPALCO BLVD",
            "address_2": "2ND FLOOR",
            "city": "MARRERO",
            "state": "LA",
            "postal_code": "700724268",
            "telephone_number": "504-340-2401",
            "fax_number": "504-340-2423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5132 LAPALCO BLVD",
            "address_2": "2ND FLOOR",
            "city": "MARRERO",
            "state": "LA",
            "postal_code": "700724268",
            "telephone_number": "504-340-2401",
            "fax_number": "504-340-2423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANTHONY INDOVINA A P D C",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-09",
        "last_updated": "2011-02-09",
        "status": "A",
        "authorized_official_last_name": "INDOVINA",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "504-340-2401",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Sr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "LA",
            "license": "2650",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "600034",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1826502",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marrero, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2011; 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.