Provider Demographics
NPI:1962550301
Name:FIGUEROA, JOSE JOHN (DMD)
Entity type:Individual
Prefix:DR
First Name:JOSE
Middle Name:JOHN
Last Name:FIGUEROA
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 VETERANS MEMORIAL BLVD
Mailing Address - Street 2:STE. 302
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70005-2852
Mailing Address - Country:US
Mailing Address - Phone:504-831-7339
Mailing Address - Fax:504-831-7774
Practice Address - Street 1:1000 VETERANS MEMORIAL BLVD
Practice Address - Street 2:STE. 302
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70005-2852
Practice Address - Country:US
Practice Address - Phone:504-831-7339
Practice Address - Fax:504-831-7774
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA52251223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
880039OtherUNITED CONCORDIA
LA1852252Medicaid