1922552132 NPI number — HILTON DENTAL, INC.

Table of content: (NPI 1922552132)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1922552132 NPI number — HILTON DENTAL, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HILTON DENTAL, INC.
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:
1922552132
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/05/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3750 PARLIAMENT DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ALEXANDRIA
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
71303-3011
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
318-443-4466
Provider Business Mailing Address Fax Number:
318-443-4811

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3750 PARLIAMENT DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ALEXANDRIA
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
71303-3011
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
318-443-4466
Provider Business Practice Location Address Fax Number:
318-443-4811
Provider Enumeration Date:
08/05/2016

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
HILTON
Authorized Official First Name:
DAVID
Authorized Official Middle Name:
W.
Authorized Official Title or Position:
DIRECTOR
Authorized Official Telephone Number:
318-542-1155

Provider Taxonomy Codes

  • Taxonomy code: 122300000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 1843580 , issued by the state of ( LA ) . This identifiers is of the category "MEDICAID".