Healthcare Provider Details

I. General information

NPI: 1508029257
Provider Name (Legal Business Name): SAPNA ARVIND PATEL DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/02/2008
Last Update Date: 02/17/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 BARROW ST STE 317
HOUMA LA
70360-4764
US

IV. Provider business mailing address

610 JEFFERSON PARK AVE
JEFFERSON LA
70121-1612
US

V. Phone/Fax

Practice location:
  • Phone: 985-714-0983
  • Fax:
Mailing address:
  • Phone: 985-688-9878
  • Fax: 985-241-4588

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number5881
License Number StateLA
# 2
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number5881
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: