Kredenna Beverly in Baton Rouge - Pediatric Dentistry
Kredenna Beverly - NPI 1023216546
Kredenna Beverly is a Pediatric Dentistry in Baton Rouge, Louisiana. Kredenna Beverly practices all healthcare services and medical treatments related to Pediatric Dentistry. The NPI Number for Kredenna Beverly is 1023216546. The last update date is 2012-07-10.
Kredenna Beverly's current location address is 2314 Weymouth Dr., Baton Rouge, Louisiana. You can contact this provider via phone number 2259264444 and fax number 2259264050. The mailing address for Kredenna Beverly is 2314 Weymouth Dr., Baton Rouge, Louisiana. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Kredenna Beverly |
|---|---|
| Address | 2314 Weymouth Dr., Baton Rouge, Louisiana |
| Phone Number | 2259264444 |
| Fax Number | 2259264050 |
| Sole Proprietor | Y |
| Credentials | DDS |
NPI Number Detail
| NPI Number | 1023216546 |
|---|---|
| Provider Enumeration Date | 2007-07-05 |
| Last Updated Date | 2012-07-10 |
Provider Mailing Address Detail
| Address | 2314 Weymouth Dr. |
|---|---|
| City | Baton Rouge |
| State | Louisiana (LA) |
| Post Code | 708095207 |
| Phone Number | 2259264444 |
| Fax Number | 2259264050 |
Provider's Primary Taxonomy Detail
| Speciality | Pediatric Dentistry |
|---|---|
| Taxonomy | 1223P0221X |
| Licence No | 13664 |
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Definition: An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
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What is the unique 10-digit identification code issued to Kredenna Beverly by the Centers for Medicare & Medicaid Services?
The Kredenna Beverly has been assigned the NPI (National Provider Identifier) 1023216546 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for healthcare providers.
Can you provide the Kredenna Beverly's physical address?
The Kredenna Beverly is physically located at 2314 Weymouth Dr., in the city of Baton Rouge, LA, with the postal code 708095207.
What is Kredenna Beverly's primary field of medical specialization, and what is the corresponding taxonomy classification code for this area of expertise?
The primary field of medical specialization for Kredenna Beverly is Pediatric Dentistry, and the taxonomy classification code that categorizes this area of expertise is 1223P0221X.
On what date did the Centers for Medicare & Medicaid Services assign the 1023216546 to Kredenna Beverly?
The Centers for Medicare & Medicaid Services assigned the 1023216546 to Kredenna Beverly on 2007-07-05.
As of what date were the details pertaining to Kredenna Beverly last refreshed?
The information related to the Kredenna Beverly, including its address, specialty, and other relevant details, was last updated on 2012-07-10.