MEDICARE: DENTAL CARE GROUP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies
2	261QD0000X	Dental Clinic/Center	6275	LA

General Provider Information

NPI Number	:	1003245226
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DENTAL CARE GROUP

Provider Business Mailing Address
First Line	:	16270 AIRLINE HWY
Second Line	:	STE. B
City	:	PRAIRIEVILLE
State	:	LA
Zip	:	70769-4589
Country	:	US
Telephone Number	:	225-673-1557
Fax Number	:	225-673-6815

Provider Business Practice Location Address
First Line	:	16270 AIRLINE HWY
Second Line	:	STE. B
City	:	PRAIRIEVILLE
State	:	LA
Zip	:	70769-4589
Country	:	US
Telephone Number	:	225-673-1557
Fax Number	:	225-673-6815

Authorized Official
Title or Position	:	DENTIST/ OWNER
Name	:	DR. CATRINEL JORDAN
Credential	:	DDS
Telephone Number	:	225-673-1557

Provider Enumeration Date	:	11/07/2013
Last Update Date	:	06/08/2026

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Directions to “DENTAL CARE GROUP ” Practice Location

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