Provider Demographics
NPI:1053664573
Name:JIMMY A BABINEAUX JR DDS LLC
Entity Type:Organization
Organization Name:JIMMY A BABINEAUX JR DDS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JIMMY
Authorized Official - Middle Name:A
Authorized Official - Last Name:BABINEAUX
Authorized Official - Suffix:JR
Authorized Official - Credentials:DDS
Authorized Official - Phone:337-234-3214
Mailing Address - Street 1:1534 W PINHOOK RD
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70503-3159
Mailing Address - Country:US
Mailing Address - Phone:337-234-3214
Mailing Address - Fax:
Practice Address - Street 1:1534 W PINHOOK RD
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70503-3159
Practice Address - Country:US
Practice Address - Phone:337-234-3214
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-22
Last Update Date:2012-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA5880261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental