Provider Demographics
NPI:1336452846
Name:BERINGER AND RICHARDSON DENTAL PARTNERSHIP
Entity type:Organization
Organization Name:BERINGER AND RICHARDSON DENTAL PARTNERSHIP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ASLYN
Authorized Official - Middle Name:B
Authorized Official - Last Name:ANDREWS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-664-7175
Mailing Address - Street 1:703 S RANGE AVE
Mailing Address - Street 2:
Mailing Address - City:DENHAM SPRINGS
Mailing Address - State:LA
Mailing Address - Zip Code:70726-4414
Mailing Address - Country:US
Mailing Address - Phone:225-664-7175
Mailing Address - Fax:225-664-7194
Practice Address - Street 1:703 S RANGE AVE
Practice Address - Street 2:
Practice Address - City:DENHAM SPRINGS
Practice Address - State:LA
Practice Address - Zip Code:70726-4414
Practice Address - Country:US
Practice Address - Phone:225-664-7175
Practice Address - Fax:225-664-7194
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-26
Last Update Date:2010-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA26271223G0001X
LA52741223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1852741Medicaid
LA1826278Medicaid