Healthcare Provider Details

I. General information

NPI: 1093644080
Provider Name (Legal Business Name): JULIA MADELINE LANNE DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/15/2026
Last Update Date: 05/15/2026
Certification Date: 05/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2300 GAUSE BLVD E
SLIDELL LA
70461-4141
US

IV. Provider business mailing address

1209 MERCURY AVE
METAIRIE LA
70003-4131
US

V. Phone/Fax

Practice location:
  • Phone: 985-200-5175
  • Fax:
Mailing address:
  • Phone: 985-237-3905
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number7793
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: