MEDICARE: DR. KAITLYN RENEE HAWKINS DDS

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	1223G0001X	General Practice Dentistry	6850	LA

General Provider Information

NPI Number	:	1033600804
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KAITLYN RENEE HAWKINS DDS

Provider Business Mailing Address
First Line	:	10634 N OAK HILLS PKWY
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70810-0102
Country	:	US
Telephone Number	:	225-766-3474
Fax Number	:	225-766-3475

Provider Business Practice Location Address
First Line	:	10634 N OAK HILLS PKWY
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70810-0102
Country	:	US
Telephone Number	:	225-766-3474
Fax Number	:	225-766-3475

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/28/2018
Last Update Date	:	06/26/2021

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