1598909525 NPI number — DR. LYNDA HARHAD DDS

Table of content: DR. LYNDA HARHAD DDS (NPI 1598909525)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1598909525 NPI number — DR. LYNDA HARHAD DDS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HARHAD
Provider First Name:
LYNDA
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DDS
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1598909525
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/04/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1090 NORTHCHASE PKWY SE
Provider Second Line Business Mailing Address:
SUITE 290
Provider Business Mailing Address City Name:
MARIETTA
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
30067-6405
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
770-916-9000
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3445 GOVERMENT ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BATON ROUGE
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
70806
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
225-341-8332
Provider Business Practice Location Address Fax Number:
225-383-4130
Provider Enumeration Date:
04/21/2009

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1223D0001X , with the licence number:  6080 , registered in the state of LA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1860808 , issued by the state of ( LA ) . This identifiers is of the category "MEDICAID".




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