NATHAN RAY FONTENOT JR. APDC NPI 1114262649

NPI Information

  • NPI: 1114262649
  • Provider Name: NATHAN RAY FONTENOT, JR., APDC
  • Classification: Clinic/Center - 261QD0000X
  • Specialization: Dental
  • Entity Type: Organization
  • Address: 715 N MAIN ST
    JENNINGS, LA
    ZIP 70546
  • Phone: (337) 824-4963

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NPI Details

NATHAN RAY FONTENOT, JR., APDC is a dental clinic center in Jennings, LA. NATHAN RAY FONTENOT, JR., APDC NPI is 1114262649. The provider is registered as an organization entity type.

The provider's business location address is:

715 N MAIN ST
JENNINGS, LA
ZIP 70546-311
Phone: (337) 824-4963
Fax: (337) 824-4961

The provider's authorized official is Nathan Ray Fontenot .
The authorized official title is Owner/dentist and has the following contact phone number (337) 824-4963.

The enumeration date for this NPI number is 12/10/2012 and was last updated on 12/10/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QD0000XClinic/CenterDental3543LOUISIANAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
118354319MEDICAIDLOUISIANA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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