PEACH TREE FOR KIDS - RUSTON LLC NPI 1144569252

NPI Information

  • NPI: 1144569252
  • Provider Name: PEACH TREE FOR KIDS - RUSTON, LLC
  • Classification: Dentist - 1223P0221X
  • Specialization: Pediatric Dentistry
  • Entity Type: Organization
  • Address: 206 E VAUGHN AVE
    RUSTON, LA
    ZIP 71270
  • Phone: (318) 255-7760

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NPI Details

PEACH TREE FOR KIDS - RUSTON, LLC is a pediatric dentistry dentist in Ruston, LA. The provider is an age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. PEACH TREE FOR KIDS - RUSTON, LLC NPI is 1144569252. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

206 E VAUGHN AVE
RUSTON, LA
ZIP 71270-926
Phone: (318) 255-7760

The provider's authorized official is Jesse Henton Roberts .
The authorized official title is Owner/dentist and has the following contact phone number (318) 255-7760.

The enumeration date for this NPI number is 2/8/2013 and was last updated on 2/8/2013.

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
11223P0221XDentistPediatric Dentistry5205LOUISIANAYes

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: 11/21/2025

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