Elm Street Dental Center, LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

ELM STREET DENTAL CENTER, LLC

Practice address

909 Elm St
Minden, LA 71055-2747

Phone

(318) 377-9411

Fax

(318) 377-1424

NPI assigned

Feb 21, 2007

Last updated

Aug 22, 2020By 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

Mrs. Donna L Basham

Title

Office Manager

Phone

(318) 377-9411

Specialties & licenses 1

Addresses

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.

• Fred V Cabaniss, DDS

  • General Practice Dentistry
  • Minden, LA
  • NPI 1023154457
  NPD (past)
• Zachary M Goodman, DDS

  • General Practice Dentistry
  • Minden, LA
  • NPI 1184764540
  NPD (past)

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1972648186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "909 ELM ST",
            "city": "MINDEN",
            "state": "LA",
            "postal_code": "710552747",
            "telephone_number": "318-377-9411",
            "fax_number": "318-377-1424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "909 ELM ST",
            "city": "MINDEN",
            "state": "LA",
            "postal_code": "710552747",
            "telephone_number": "318-377-9411",
            "fax_number": "318-377-1424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELM STREET DENTAL CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BASHAM",
        "authorized_official_first_name": "DONNA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "318-377-9411",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dawn Duncan
• Holly Cherie Dupont, PLPC
• Christopher Michael Earnhardt, MD
• Edwin B. Moss (Moss Eyecare Center)
• Elc Medicine Group LLC
• Erin E. Soleto MD Apmc
• Evergreen Presbyterian Ministries, Inc. (NCLA Community Services-Sup.Employment)
• Evergreen Presbyterian Ministries, Inc. (NCLA Community Services-Vocational)
• Evergreen Presbyterian Ministries, Inc. (NCLA Community Services-LTPCS)
• Evergreen Presbyterian Ministries, Inc. (NCLA Community Services-SIL)

• General Practice Dentistry in Minden, LA
• Providers in Minden, 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 Aug 22, 2020; 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.