Southern Dental Care, LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

6350 Issued in LA

Legal business name

SOUTHERN DENTAL CARE, LLC

Doing business as

Southern Dental Care

Practice address

7301 Westbank Expy
Marrero, LA 70072-2448

Phone

(504) 347-1014

NPI assigned

Apr 29, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Lacey Addison Andreotta, DDSNPI 1144668856

Title

Owner, Dentist

Phone

(504) 347-1014

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Southern Dental Care Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Lacey Addison Andreotta, D.D.S.

  • General Practice Dentistry
  • Marrero, LA
  • NPI 1144668856
  NPD (past) Authorized official

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

{
    "created_epoch": "1398729600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1398729600000",
    "number": "1992115919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35330 BOND DR",
            "city": "SLIDELL",
            "state": "LA",
            "postal_code": "704606136",
            "telephone_number": "985-707-9122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7301 WESTBANK EXPY",
            "city": "MARRERO",
            "state": "LA",
            "postal_code": "700722448",
            "telephone_number": "504-347-1014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN DENTAL CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-29",
        "last_updated": "2014-04-29",
        "status": "A",
        "authorized_official_last_name": "ANDREOTTA",
        "authorized_official_first_name": "LACEY",
        "authorized_official_middle_name": "ADDISON",
        "authorized_official_title_or_position": "OWNER, DENTIST",
        "authorized_official_telephone_number": "504-347-1014",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "LA",
            "license": "6350",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1863505",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southern Dental Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Thelma Sonza, N.P.
• Damien Sorapuru
• Cheryl Miller Sosa, LPN
• Rosanna Soto, M.S., CCC-SLP
• Southern Dental Care, Inc
• Southern Surgical Specialists, LLC
• Spa L'Eau de Nouvelle Orleans
• Rachel Shelea Spears, M.D.
• Sandra L Spedale, MD
• Megan Speer

• General Practice Dentistry in Marrero, LA
• Providers in Marrero, 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 Apr 29, 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.