PERIODONTICS AND IMPLANT CENTER LLC (NPI# 1023350543) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023350543 |
| Entity Type | Organization |
| Organization Name | PERIODONTICS AND IMPLANT CENTER LLC |
| Practice Address |
8202 Kelwood Ave Baton Rouge LA 70806-4801 |
| Mailing Address |
4451 Bluebonnet Blvd Suite F Baton Rouge LA 70809-9646 |
| Practice Telephone | 2257672273 |
| Mailing Telephone | 2257672273 |
| Enumeration Date | 2013-03-22 |
| Last Update Date | 2013-03-22 |
| Authorized Official Name | ANDRE BRUNI (OWNER) |
| Authorized Official Telephone | 2257672273 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0300X |
Dentist Specialization: Periodontics |
5315 | LA | Dental Providers |
| Street Address |
8202 KELWOOD AVE |
| City | BATON ROUGE |
| State | LA |
| Zip Code | 70806-4801 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245329713 | Bruce Merle Lovelace IIi | Dentist | 8202 Kelwood Ave, Baton Rouge, LA 70806-4801 | 2006-10-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467064790 | Horizon Network LLC | Community/Behavioral Health | 921 Lobdell Blvd Suite D, Baton Rouge, LA 70806 | 2020-08-18 |
| 1093324220 | Raghu Rudraraju | Student in an Organized Health Care Education/Training Program | 3401 North Boulevard Baton Rouge General Mid City Medi, Suite 130, Baton Rouge, LA 70806 | 2020-07-23 |
| 1619595584 | Brown's Pharmacy, LLC | Pharmacy | 1718 North Foster Drive, Suite B, Baton Rouge, LA 70806 | 2020-07-08 |
| 1497374847 | Yara Mouawad | Student in an Organized Health Care Education/Training Program | 3401 North Boulevard, Suite 130, Baton Rouge, LA 70806 | 2020-04-15 |
| 1396364527 | Sai Samyuktha Bandaru | Student in an Organized Health Care Education/Training Program | Brg Mid City Medicine Clinic, 3401 North Boulevard, Sui, Baton Rouge, LA 70806 | 2020-04-08 |
| 1588299812 | Iraneeka S Gustave | Peer Specialist | Kelwood Ave, 8326 Kelwood Ave, Baton Rouge, LA 70806 | 2020-03-06 |
| 1518522192 | Silpita Katragadda | Student in an Organized Health Care Education/Training Program | 3401 North Boulevard, Brg Midcity Medicine Clinic, Suite 130, Baton Rouge, LA 70806 | 2019-05-08 |
| 1437713997 | Dental Solutions, LLC | Dentist | 5629 Government St, Baton Rouge, LA 70806 | 2019-04-30 |
| 1699249516 | Shea Lafountain | Counselor | 624 Connell's Park Lane, Baton Rouge, LA 70806 | 2019-01-14 |
| 1033682802 | Genesis Specialty Groups, LLC | Clinic/Center | 778 Chevelle Drive, Baton Rouge, LA 70806 | 2019-01-04 |
| Find all providers in zip 70806 | ||||
| Taxonomy Code | 1223P0300X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Periodontics |
| That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437713997 | Dental Solutions, LLC | Dentist | 5629 Government St, Baton Rouge, LA 70806 | 2019-04-30 |
| 1528583945 | Baton Rouge Perio, L.L.C. | Dentist | 10723 N. Oak Hills Parkway, Bldg. B, Baton Rouge, LA 70810 | 2017-08-07 |
| 1871706812 | John Kenneth Legleu Jr. | Dentist | 12071 Bricksome Dr, Baton Rouge, LA 70816 | 2007-05-07 |
| 1902920606 | Maurice B Garrett | Dentist | 12071 Bricksome Ave, Baton Rouge, LA 70816-2339 | 2007-03-19 |
| 1235205659 | Dr Bruce M Lovelace IIi A Professional Corporation | Dentist | 8202 Kelwood Avenue, Baton Rouge, LA 70806 | 2006-11-28 |
| 1245329713 | Bruce Merle Lovelace IIi | Dentist | 8202 Kelwood Ave, Baton Rouge, LA 70806-4801 | 2006-10-12 |
| 1962422121 | Kenneth Ford Markle | Dentist | 10723 N Oak Hills Pkwy, Suite C, Baton Rouge, LA 70810-2862 | 2006-07-20 |
| 1740360494 | Kathy M Abbott | Dentist | 10723 N Oak Hills Pkwy, Baton Rouge, LA 70810 | 2006-10-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548532930 | Jyoti Puri | Dentist | 1900 Perdido St Apt A54, New Orleans, LA 70112-1369 | 2012-02-01 |
| 1366714750 | Manrat Amornporncharoen | Dentist | 3624 S Loyola Dr Apt 256, Kenner, LA 70065-5499 | 2012-02-01 |
| 1538456207 | Eric Christopher Hebert | Dentist | 3521 N Arnoult Rd, Suite A, Metairie, LA 70002-3395 | 2011-07-01 |
| 1518296482 | Pooja Maney | Dentist | 1100, Florida Avenue, # 131, New Orleans, LA 70119 | 2009-12-23 |
| 1386842995 | Caesar Sweidan | Dentist | 5024 Keystone Blvd Ste A, Covington, LA 70433-7517 | 2007-07-05 |
| 1225242746 | Ana Margarita Saenz | Dentist | 337 Metairie Rd, Suite 301, Metairie, LA 70005-4338 | 2007-05-10 |
| 1104047976 | Hisham F Nasr | Dentist | 337 Metairie Road, Suite 301, Metairie, LA 70005 | 2007-05-01 |
| 1497971691 | Daniel Davis Gammage | Dentist | 215 Saint Ann Dr Ste 1, Mandeville, LA 70471-3394 | 2007-04-17 |
| 1073738985 | James E Fagan | Dentist | 2301 N Hwy 190, Suite #1, Covington, LA 70433 | 2007-04-16 |
| 1619192762 | James Eric Lavespere | Dentist | 2800 Kilpatrick Blvd, Monroe, LA 71201-5139 | 2007-04-16 |
| Find all providers with the same taxonomy | ||||
| City | BATON ROUGE |
| Zip Code | 70806 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.