Provider Demographics
NPI:1013374644
Name:DUSTIN JOUBERT DDS INC
Entity Type:Organization
Organization Name:DUSTIN JOUBERT DDS INC
Other - Org Name:JOUBERT FAMILY DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DUSTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:JOUBERT
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:337-824-2422
Mailing Address - Street 1:806 N. MAIN ST
Mailing Address - Street 2:
Mailing Address - City:JENNINGS
Mailing Address - State:LA
Mailing Address - Zip Code:70546
Mailing Address - Country:US
Mailing Address - Phone:337-824-2422
Mailing Address - Fax:337-824-0047
Practice Address - Street 1:806 N MAIN ST
Practice Address - Street 2:
Practice Address - City:JENNINGS
Practice Address - State:LA
Practice Address - Zip Code:70546-4728
Practice Address - Country:US
Practice Address - Phone:337-824-2422
Practice Address - Fax:337-824-0047
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-27
Last Update Date:2023-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1834394Medicaid