Healthcare Provider Details

I. General information

NPI: 1942197678
Provider Name (Legal Business Name): BRIGHTLY DENTAL, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/24/2025
Last Update Date: 06/25/2025
Certification Date: 06/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

320 AUSTIN ST
BOGALUSA LA
70427-3857
US

IV. Provider business mailing address

320 AUSTIN ST
BOGALUSA LA
70427-3857
US

V. Phone/Fax

Practice location:
  • Phone: 985-735-7653
  • Fax: 985-735-7688
Mailing address:
  • Phone: 985-735-7653
  • Fax: 985-735-7688

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: KEITH LUMINAIS
Title or Position: OWNER
Credential: DDS
Phone: 985-735-7653