NPIMap

Organization Active NPI

Corey a. Robertson, DDS a Professional Dental Corporation

  • Dentist
  • Baton Rouge, LA
National Provider Identifier
1821408683
Registry record updated May 2, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
4907 Issued in LA
Legal business name
COREY A. ROBERTSON, DDS A PROFESSIONAL DENTAL CORPORATION
Practice address
3203 S Sherwood Forest Blvd
Baton Rouge, LA 70816-2220
Phone
(225) 201-0511
NPI assigned
May 2, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 2, 2014

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

Authorized official

Name
Crystal R Perry
Title
Manager
Phone
(252) 520-3241

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 4907 LA Primary

Addresses

Primary practice location

3203 S Sherwood Forest Blvd
Baton Rouge, LA 70816-2220

Mailing address

3203 S Sherwood Forest Blvd
Baton Rouge, LA 70816-2220
Phone (225) 201-0511

National Provider Directory

National Provider Directory
Tax ID family
Corey a Robertson a Professional Dental Corporation2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1398988800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1398988800000",
    "number": "1821408683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3203 S SHERWOOD FOREST BLVD",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708162220",
            "telephone_number": "225-201-0511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3203 S SHERWOOD FOREST BLVD",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708162220",
            "telephone_number": "225-201-0511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COREY A. ROBERTSON, DDS A PROFESSIONAL DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-02",
        "last_updated": "2014-05-02",
        "status": "A",
        "authorized_official_last_name": "PERRY",
        "authorized_official_first_name": "CRYSTAL",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "252-520-3241"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "LA",
            "license": "4907",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baton Rouge, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2014; 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.