Healthcare Provider Details

I. General information

NPI: 1265753800
Provider Name (Legal Business Name): ASCENSION DENTAL ASSOCIATES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/17/2010
Last Update Date: 10/08/2025
Certification Date: 10/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40470 GERMANY RD
GONZALES LA
70737-6735
US

IV. Provider business mailing address

40470 GERMANY RD
GONZALES LA
70737-6735
US

V. Phone/Fax

Practice location:
  • Phone: 225-622-2022
  • Fax: 225-622-2030
Mailing address:
  • Phone: 225-622-2022
  • Fax: 225-622-2030

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number3427
License Number StateLA

VIII. Authorized Official

Name: JOSEPH LACOSTE JR.
Title or Position: OWNER
Credential: DDS
Phone: 985-893-2240