Healthcare Provider Details

I. General information

NPI: 1386575264
Provider Name (Legal Business Name): MADISON MASCAGNI DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/28/2026
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

430 W 5TH ST
LA PLACE LA
70068-3934
US

IV. Provider business mailing address

139 SPENCER AVE
NEW ORLEANS LA
70124-2128
US

V. Phone/Fax

Practice location:
  • Phone: 985-652-9616
  • Fax:
Mailing address:
  • Phone: 318-737-8555
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number7796
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: