Sally B Daly DDS LLC

Primary specialty

DentistTaxonomy code 122300000X

License

3767-14 Issued in MS

Legal business name

SALLY B DALY DDS LLC

Doing business as

Fleur De Lis Mobile Dental

Practice address

11822 Justice Avenue #84
Baton Rouge, LA 70816

Phone

(225) 767-5343

Fax

(225) 767-4009

NPI assigned

Jan 12, 2017

Organization subpart

No

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

Authorized official

Name

Sally B Daly, DDS

Title

Owner

Phone

(303) 810-5619

Specialties & licenses 1

Addresses

Other names 1

• Fleur De Lis Mobile Dental Doing business as

Tax ID family

Fleur de Lis Mobile Dental2 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.

• Sally B. Daly DDS LLC

  dba Fleur de Lis Mobile Dental

  • Dental Clinic/Center
  • Baton Rouge, LA
  • NPI 1174993661
  NPD tax ID

Locations

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

{
    "created_epoch": "1484179200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1484179200000",
    "number": "1932645041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 40992",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708350992",
            "telephone_number": "225-767-5343",
            "fax_number": "225-767-4009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11822 JUSTICE AVENUE #84",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "70816",
            "telephone_number": "225-767-5343",
            "fax_number": "225-767-4009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SALLY B DALY DDS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-12",
        "last_updated": "2017-01-12",
        "status": "A",
        "authorized_official_last_name": "DALY",
        "authorized_official_first_name": "SALLY",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "303-810-5619",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "MS",
            "license": "3767-14",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fleur De Lis Mobile Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Amir Saleem, CRNA
• Malika Saleh, RN
• Markayla J Salisberry
• Daniel Robert Salisbury, M.D.
• Ashkan Saljoghi-Badlo
• Sally B. Daly DDS LLC (Fleur de Lis Mobile Dental)
• Melody Salmanian
• Russell J. Saloom, M.D.
• Trinity Purvis Salter, P.T.
• Patricia Salton-Hobson

• Dentist in Baton Rouge, LA
• Providers in Baton Rouge, LA by specialty
• Dentist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2017; 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.