W . JARROD GREGG DDS LLC NPI 1407479819

NPI Information

  • NPI: 1407479819
  • Provider Name: W . JARROD GREGG, DDS, LLC
  • Classification: Clinic/Center - 261QD0000X
  • Specialization: Dental
  • Entity Type: Organization
  • Address: 1148 LOGAN SEWELL DR
    VIDALIA, LA
    ZIP 71373
  • Phone: (318) 336-5711

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NPI Details

W . JARROD GREGG, DDS, LLC is a dental clinic center in Vidalia, LA. W . JARROD GREGG, DDS, LLC NPI is 1407479819. The provider is registered as an organization entity type.

The provider's business location address is:

1148 LOGAN SEWELL DR
VIDALIA, LA
ZIP 71373-342
Phone: (318) 336-5711

The provider's authorized official is Melissa W Gregg .
The authorized official title is Office Manager and has the following contact phone number (318) 336-5711.

The enumeration date for this NPI number is 5/20/2020 and was last updated on 5/20/2020.

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/CenterDentalYes

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
129821MEDICAIDLOUISIANA

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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