Provider Demographics
NPI:1104981059
Name:PARKER LONG, AUKENA P (DDS)
Entity type:Individual
Prefix:
First Name:AUKENA
Middle Name:P
Last Name:PARKER LONG
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5961 BULLARD AVE
Mailing Address - Street 2:SUITE 4
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70128-2817
Mailing Address - Country:US
Mailing Address - Phone:504-240-3181
Mailing Address - Fax:504-240-3188
Practice Address - Street 1:5961 BULLARD AVE
Practice Address - Street 2:SUITE 4
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70128-2817
Practice Address - Country:US
Practice Address - Phone:504-240-3181
Practice Address - Fax:504-240-3188
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-22
Last Update Date:2012-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA5378122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist