=====================================================
General NPI Number Information
=====================================================
NPI Number | 1487116513
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MARLA ELLYN BARIENT DDS
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/06/2019
-----------------------------------------------------
Last Update Date | 01/07/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 27403 US-190
-----------------------------------------------------
City | LACOMBE
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 70445
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 985-218-9445
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2804 W THOMAS ST
-----------------------------------------------------
City | HAMMOND
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 70401-2841
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 985-260-8552
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1223G0001X
-----------------------------------------------------
Taxonomy Name | General Practice Dentistry
-----------------------------------------------------
License Number | 6953
-----------------------------------------------------
License Number State | LA
-----------------------------------------------------