J & J Dental

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

5843 Issued in LA

Legal business name

J & J DENTAL

Doing business as

Peach Tree Dental Monroe

Practice address

2024 Forsythe Ave
Monroe, LA 71201-3609

Phone

(318) 325-4220

Fax

(318) 323-4362

NPI assigned

Dec 12, 2008

Last updated

Jan 15, 2009By 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. Jesse Henton Roberts III, D.M.D.

Title

President

Phone

(318) 325-4220

Specialties & licenses 4

Addresses

Other names 1

• Peach Tree Dental Monroe Doing business as

Locations

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

{
    "created_epoch": "1229040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1231977600000",
    "number": "1881839231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2024 FORSYTHE AVE",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712013609",
            "telephone_number": "318-325-4220",
            "fax_number": "318-323-4362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2024 FORSYTHE AVE",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712013609",
            "telephone_number": "318-325-4220",
            "fax_number": "318-323-4362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "J & J DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-12",
        "last_updated": "2009-01-15",
        "status": "A",
        "authorized_official_last_name": "ROBERTS",
        "authorized_official_first_name": "JESSE",
        "authorized_official_middle_name": "HENTON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "318-325-4220",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "LA",
            "license": "5205",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "LA",
            "license": "5807",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "LA",
            "license": "3586",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "LA",
            "license": "5843",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Peach Tree Dental Monroe",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• J. Scott Caldwell, D. C., a Professional Chiropractic Corporation (Doctor's Center)
• Ned Michael Jabour Sr., PH.D., LPC

• General Practice Dentistry in Monroe, LA
• Providers in Monroe, 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 Jan 15, 2009; 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.