DUBOUE DENTAL LLC NPI 1245494814

NPI Information

  • NPI: 1245494814
  • Provider Name: DUBOUE DENTAL LLC
  • Classification: Dentist - 122300000X
  • Entity Type: Organization
  • Other Name: LAKETOWN DENTAL
  • CLIA Number: 19D2178767
  • Address: 4134 FLORIDA AVE STE 101
    KENNER, LA
    ZIP 70065
  • Phone: (504) 218-4444

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NPI Details

DUBOUE DENTAL LLC is a dentist in Kenner, LA. The provider is a dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. DUBOUE DENTAL LLC NPI is 1245494814. The provider is registered as an organization entity type and is a single specialty group.
The provider Other Name Is Laketown Dental.

The provider's business location address is:

4134 FLORIDA AVE STE 101
KENNER, LA
ZIP 70065-190
Phone: (504) 218-4444
Fax: (504) 218-4204

The provider's authorized official is Jaclyn Duboue .
The authorized official title is Dentist Owner and has the following contact phone number (504) 390-2847.

The CLIA number assigned to this NPI record is 19D2178767 - assisted living facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/14/2008 and was last updated on 1/19/2016.

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
1122300000XDentist5635LOUISIANAYes

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
11856355MEDICAIDLOUISIANA

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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