Provider Demographics
NPI:1043816895
Name:SUNNY DAY PEDIATRIC DENTISTRY
Entity Type:Organization
Organization Name:SUNNY DAY PEDIATRIC DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PEDIATRIC DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:
Authorized Official - Last Name:DAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-924-2010
Mailing Address - Street 1:541 SHADOWS LN STE B
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70806-6559
Mailing Address - Country:US
Mailing Address - Phone:225-924-2010
Mailing Address - Fax:225-926-5872
Practice Address - Street 1:541 SHADOWS LN STE B
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70806-6559
Practice Address - Country:US
Practice Address - Phone:225-573-2777
Practice Address - Fax:225-926-5872
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-08
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA34651Medicaid