1093529612 NPI number — ACCESSNOW PROFESSIONAL SERVICES, LLC

Table of content: DR. DIANA M. PENA D.D.S. (NPI 1801016803)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1093529612 NPI number — ACCESSNOW PROFESSIONAL SERVICES, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ACCESSNOW PROFESSIONAL SERVICES, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

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:
1093529612
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/04/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10 VICKSBURG CT
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HARVEY
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
70058-6117
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
504-452-3622
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1128 HENDEE ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEW ORLEANS
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
70114-2625
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
504-452-3622
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/04/2025

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
WILLIAMS
Authorized Official First Name:
SHONDRA
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT & CEO
Authorized Official Telephone Number:
504-452-3622

Provider Taxonomy Codes

  • Taxonomy code: 253Z00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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