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General NPI Number Information
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NPI Number | 1164097069
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Entity Type | Individual
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Provider Name | LENNON COON DDS
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Gender | Male
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Dates
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Enumeration Date | 05/24/2021
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Last Update Date | 05/24/2021
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Provider Practice Location Address
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Address Line | 1501 32ND ST
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City | KENNER
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State | LA
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Zip | 70065-3204
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Country | US
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Telephone | 504-287-4467
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Fax |
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Provider Business Mailing Address
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Address Line | 319 38TH ST
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City | NEW ORLEANS
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State | LA
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Zip | 70124-1521
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Country | US
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Telephone | 318-381-0503
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 7179
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 7179
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License Number State | LA
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