Provider Demographics
NPI:1043368699
Name:MINVIELLE, JULES ERNEST JR (DDS)
Entity Type:Individual
Prefix:DR
First Name:JULES
Middle Name:ERNEST
Last Name:MINVIELLE
Suffix:JR
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:116 PEACE ST
Mailing Address - Street 2:
Mailing Address - City:ABBEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70510-5145
Mailing Address - Country:US
Mailing Address - Phone:337-898-2489
Mailing Address - Fax:
Practice Address - Street 1:116 PEACE ST
Practice Address - Street 2:
Practice Address - City:ABBEVILLE
Practice Address - State:LA
Practice Address - Zip Code:70510-5145
Practice Address - Country:US
Practice Address - Phone:337-898-2572
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2011-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA40361223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1840360Medicaid