Healthcare Provider Details

I. General information

NPI: 1821927476
Provider Name (Legal Business Name): MADELYN LESLIE LOESCHER DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/18/2026
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 OLD SPANISH TRL STE B
SLIDELL LA
70458-5024
US

IV. Provider business mailing address

1400 OLD SPANISH TRL STE B
SLIDELL LA
70458-5024
US

V. Phone/Fax

Practice location:
  • Phone: 985-643-6620
  • Fax:
Mailing address:
  • Phone: 985-643-6620
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number7794
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: