LOUISIANA ORAL & IMPLANT SURGERY (NPI# 1932759271) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932759271 |
| Entity Type | Organization |
| Organization Name | LOUISIANA ORAL & IMPLANT SURGERY |
| Other Organization Name | LOUISIANA ORAL AND IMPLANT SURGERY |
| Practice Address |
4720 Lake Street Lake Charles LA 70605 |
| Practice Telephone | 3378884771 |
| Practice Fax Number | 3378884772 |
| Mailing Telephone | 3378884771 |
| Mailing Fax Number | 3378884772 |
| Enumeration Date | 2019-09-18 |
| Last Update Date | 2019-12-23 |
| Authorized Official Name | NICKOLAS MASKAS (ORAL AND MAXILLOFACIAL SURGEON/OWNE) |
| Authorized Official Telephone | 3378884771 |
| Authorized Official Credential | DDS, MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QS0112X |
Clinic/Center Specialization: Oral and Maxillofacial Surgery |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Louisiana Oral and Implant Surgery | Doing Business As Name - Organization |
| Street Address |
4720 LAKE STREET |
| City | LAKE CHARLES |
| State | LA |
| Zip Code | 70605 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679913222 | Nickolas Stanley Maskas | Dentist | 4720 Lake Street, Lake Charles, LA 70605 | 2013-06-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780283606 | Kristin R Morris | Clinical Nurse Specialist | 1900 W. Gaythier Rd, Lake Charles, LA 70605 | 2020-10-21 |
| 1548871577 | Jacob M Theriot | Nurse Practitioner | 2640 County Club Rd., Lake Charles, LA 70605 | 2020-08-13 |
| 1053898403 | Heather Spallino Duplechain | Nurse Practitioner | 6713 Nelson Rd., Lake Charles, LA 70605 | 2018-07-27 |
| 1578057956 | Noor Deeb Weckerly | Nurse Practitioner | 6713 Nelson Rd, Lake Charles, LA 70605 | 2018-06-19 |
| 1861993354 | Therapy Works of Swla LLC | Physical Therapist | 4750 Lake Street, Lake Charles, LA 70605 | 2018-02-21 |
| 1669998852 | Amd Healthcare Lc, LLC | General Acute Care Hospital | 3730 Nelson Road, Lake Charles, LA 70605 | 2017-08-18 |
| 1619422474 | Kaitlyn Pinkerton | Specialist/Technologist | 800 E Mcneese St, Lake Charles, LA 70605 | 2016-08-22 |
| 1104274679 | Kelly Rogers | Counselor | 90 N. Luke 102l, Lafayette, LA 70605 | 2016-05-25 |
| 1548616220 | Lisa Monticello Snider | Neurological Surgery | 3297 Portrush Drive, Lake Charles, LA 70605 | 2016-05-11 |
| 1114387404 | Louisiana Dental Professionals, Donovan Dronet, Dds, A Professional De | Dentist | 4459 Nelson Rd, Suite 120, Lake Charles, LA 70605 | 2016-02-29 |
| Find all providers in zip 70605 | ||||
| Taxonomy Code | 261QS0112X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| 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 |
|---|---|---|---|---|
| 1497054613 | Oral Surgery Associates | Clinic/Center | 2120 Bert Kouns Loop Ste D, Shreveport, LA 71118-3351 | 2011-03-28 |
| City | LAKE CHARLES |
| Zip Code | 70605 |
Please comment or provide details below to improve the information on LOUISIANA ORAL & IMPLANT SURGERY.
| 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.