Healthcare Provider Details

I. General information

NPI: 1902732449
Provider Name (Legal Business Name): JOSEPH PAUL TASSIN JR. DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

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

III. Provider practice location address

1530 E MCNEESE ST STE 5
LAKE CHARLES LA
70607-4784
US

IV. Provider business mailing address

4508 COUNTRY CLUB PL
LAKE CHARLES LA
70605-5943
US

V. Phone/Fax

Practice location:
  • Phone: 337-529-2380
  • Fax:
Mailing address:
  • Phone: 337-529-2380
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number7828
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: