B&L Dental, LLC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

B&L DENTAL, LLC

Practice address

4279 Highway 15
Mangham, LA 71259-5189

Phone

(318) 248-4986

Fax

(318) 248-3379

NPI assigned

Apr 16, 2024

Last updated

Apr 16, 2024By 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

Dr. Jennifer Boles, DDSNPI 1386754620

Title

Owner

Phone

(318) 248-4986

Specialties & licenses 1

Addresses

Tax ID family

BL Dental LLC2 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.

• B&L Dental, LLC

  dba Southern Smiles

  • Dentist
  • Rayville, LA
  • NPI 1043064074
  NPD tax ID

Locations

Practitioners 1

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.

• Jennifer Newton Boles, DDS

  • General Practice Dentistry
  • Mangham, LA
  • NPI 1386754620
  NPD Authorized official

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

{
    "created_epoch": "1713225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713225600000",
    "number": "1881448819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4279 HIGHWAY 15",
            "city": "MANGHAM",
            "state": "LA",
            "postal_code": "712595189",
            "telephone_number": "318-248-4986",
            "fax_number": "318-248-3379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4279 HIGHWAY 15",
            "city": "MANGHAM",
            "state": "LA",
            "postal_code": "712595189",
            "telephone_number": "318-248-4986",
            "fax_number": "318-248-3379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "B&L DENTAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-16",
        "last_updated": "2024-04-16",
        "certification_date": "2024-04-16",
        "status": "A",
        "authorized_official_last_name": "BOLES",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "318-248-4986",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Affinity Health Group, LLC (Abraham Medical Clinic)
• Jennifer Newton Boles, DDS
• Kayla D Bridges, P.D.
• Bullock Medical Transportation LLC
• Shayna Bullock
• Central Medical Transportation

• Dentist in Mangham, LA
• Providers in Mangham, LA by specialty
• Dentist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2024; 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.