Healthcare Provider Details

I. General information

NPI: 1134053234
Provider Name (Legal Business Name): GIARRUSSO DENTAL GROUP, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/11/2026
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1868 SHORTCUT HWY
SLIDELL LA
70458-8050
US

IV. Provider business mailing address

1868 SHORTCUT HWY
SLIDELL LA
70458-8050
US

V. Phone/Fax

Practice location:
  • Phone: 985-502-1714
  • Fax:
Mailing address:
  • Phone: 985-502-1714
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. MONIQUE GIARRUSSO
Title or Position: OWNER
Credential: DMD
Phone: 985-502-1714