Healthcare Provider Details

I. General information

NPI: 1174844450
Provider Name (Legal Business Name): ERIN AINSLEY FONTENOT D.D.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/21/2010
Last Update Date: 04/22/2026
Certification Date: 04/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

913 S COLLEGE RD STE 108
LAFAYETTE LA
70503-3061
US

IV. Provider business mailing address

913 S COLLEGE RD STE 108
LAFAYETTE LA
70503-3061
US

V. Phone/Fax

Practice location:
  • Phone: 337-233-8623
  • Fax: 337-769-3942
Mailing address:
  • Phone: 337-233-8623
  • Fax: 337-769-3942

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number9549
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number6078
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: