Healthcare Provider Details

I. General information

NPI: 1750082426
Provider Name (Legal Business Name): JASPREET AHLUWALIA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/10/2023
Last Update Date: 07/28/2025
Certification Date: 07/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4607 SHERWOOD COMMON BLVD BLDG 1
BATON ROUGE LA
70816-4892
US

IV. Provider business mailing address

6726 FLEUR DE LIS DR
NEW ORLEANS LA
70124-1542
US

V. Phone/Fax

Practice location:
  • Phone: 225-924-6622
  • Fax:
Mailing address:
  • Phone: 337-326-6443
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number7409
License Number StateLA
# 2
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number7409
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: