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JAN T BAGWELL DDS NPI 1669945861


NPI Information

NPI: 1669945861
Provider Name: JAN T BAGWELL DDS
Classification: Clinic/Center - 261QD0000X
Entity Type: Organization

Specialization: Dental

Address:
189 KEYSTONE RD
MONROE, LA
ZIP 71203
Phone: (318) 665-4423
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JAN T BAGWELL DDS is a dental clinic center in Monroe, LA. JAN T BAGWELL DDS NPI is 1669945861. The provider is registered as an organization entity type.

The provider's business location address is:

189 KEYSTONE RD
MONROE, LA
ZIP 71203-936
Phone: (318) 665-4423

The provider's authorized official is Jan T Bagwell .
The authorized official title is Owner and has the following contact phone number (318) 665-4423.

The enumeration date for this NPI number is 1/10/2019 and was last updated on 1/10/2019.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QD0000XClinic/CenterDentalYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11760917561OTHERLOUISIANANATIONAL PROVIDER NUMBER/ NPI

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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