EDWARD C MASSETT JR. DDS APC (NPI# 1154877686) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1154877686 |
Entity Type | Organization |
Organization Name | EDWARD C MASSETT JR. DDS APC |
Practice Address |
2334 Gause Blvd E Slidell LA 70461-4141 |
Mailing Address |
2334 Gause Blvd. East Slidell LA 70461 |
Practice Telephone | 9856412030 |
Practice Fax Number | 9856450272 |
Mailing Telephone | 9856412030 |
Mailing Fax Number | 9856450272 |
Enumeration Date | 2016-08-25 |
Last Update Date | 2016-08-25 |
Authorized Official Name | DR. CHRISTOPHER BRADLEY DICKERSON (OWNER) |
Authorized Official Telephone | 9856412030 |
Authorized Official Credential | D.D.S., M.D. |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
LA | Dental Providers | |
Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
2368 | LA | Dental Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
LA | 1857149 | 05 | |
LA | 1823686 | 05 |
Street Address |
2334 GAUSE BLVD E |
City | SLIDELL |
State | LA |
Zip Code | 70461-4141 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1760521496 | Kelly Marie Meilleur | Dentist | 2334 Gause Blvd E, Slidell, LA 70461-4141 | 2007-02-06 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1013553577 | Kira Gilmore Smith | Nurse Practitioner | Pelican Urgent Care, 2375 Gause Blvd. East, Slidell, LA 70461 | 2019-11-20 |
1104477256 | Peter Khong | Pharmacy | 2915 Us-190, Mandeville, LA 70461 | 2019-09-20 |
1457844706 | April Hughes Whitfield | Counselor | 1313 Brownswitch Rd, Ste D, Slidell, LA 70461 | 2018-06-12 |
1154824761 | Lisa Michele Mcclinton | Counselor | 1212 Montgomery Blvd, Slidell, LA 70461 | 2018-03-10 |
1952816902 | Keiona Monae Thompson | Counselor | 1121 Clairise Ct, Slidell, LA 70461 | 2017-12-12 |
1275048688 | Aisha Cade | Counselor | 250 Cross Gates Blvd, Slidell, LA 70461 | 2017-12-07 |
1598285405 | Sureway Transits | Non-emergency Medical Transport (VAN) | 135 Rue De La Paix, Slidell, LA 70461 | 2017-06-21 |
1043743198 | Natasha Hunter | Counselor | 1650 Barrymore St, Slidell, LA 70461 | 2017-04-05 |
1154873891 | Chaise A Bennett | Physical Therapist | 2040 Gause Blvd, Suite 6, Slidell, LA 70461 | 2016-10-28 |
1104373539 | Kaonta Simmons | Counselor | 2185 Wellington Ln, Slidell, LA 70461 | 2016-09-01 |
Find all providers in zip 70461 |
Taxonomy Code | 1223S0112X |
Grouping | Dental Providers |
Classification | Dentist |
Specialization | Oral and Maxillofacial Surgery |
The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
Notes: Source: Council on Dental Education and Licensure, American Dental Association |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1659340834 | Russell L Westfall | Dentist | 1271 7th St, Slidell, LA 70458-2041 | 2006-03-17 |
1689925539 | Northlake Oral and Facial Surgery LLC | Dentist | 1271 7th St, Slidell, LA 70458-2041 | 2012-10-01 |
1902981921 | Craig J Brandner | Dentist | 2364 Gause Blvd E, Suite 102, Slidell, LA 70461-4141 | 2006-10-26 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1346868676 | Cypress Bend Oral & Maxillofacial Surgery | Dentist | 106 Rue Bastille, Lafayette, LA 70508 | 2020-07-13 |
1578089603 | Ardoin-kennedy LLC | Dentist | 203 A Energy Parkway, Lafayette, LA 70508 | 2017-08-21 |
1932583358 | Oral Surgery& Dental Implant Center of Louisiana | Dentist | 16206 Airline Hwy, Prairieville, LA 70769-4248 | 2015-07-15 |
1588078224 | Ricardo Lugo | Dentist | 1501 Kings Hwy Rm 530, Shreveport, LA 71103-4228 | 2014-06-19 |
1184059818 | Yasser Saad Alali | Dentist | 5243 Butter Creek, Unit H7, Baton Rouge, LA 70809-0603 | 2013-09-12 |
1679913222 | Nickolas Stanley Maskas | Dentist | 4720 Lake Street, Lake Charles, LA 70605 | 2013-06-27 |
1720354822 | John Ben Ragusa | Dentist | 16819 Cherry Bark Dr, Baton Rouge, LA 70810-5811 | 2012-03-22 |
1871882480 | Andrew Frederick Wetterlind | Dentist | 13730 Millerville Greens Blvd, Baton Rouge, LA 70816-1696 | 2011-04-04 |
1932415007 | Dr. David M. Vieth Dds, A Professional Corporation | Dentist | 91 Westbank Expy, Suite 345, Gretna, LA 70053-3615 | 2010-08-26 |
1871757187 | George Rawleigh Fisher | Dentist | 1624 Wolf Cir, Lake Charles, LA 70605 | 2008-07-16 |
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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.