Provider Demographics
NPI:1093997389
Name:JEANSONNE, BILLIE GRIGGS (DDS)
Entity Type:Individual
Prefix:DR
First Name:BILLIE
Middle Name:GRIGGS
Last Name:JEANSONNE
Suffix:
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 1:1100 FLORIDA AVE
Mailing Address - Street 2:LSUSD ENDODONTICS, ROOM 4312
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70119-2714
Mailing Address - Country:US
Mailing Address - Phone:504-941-8395
Mailing Address - Fax:504-941-8400
Practice Address - Street 1:1100 FLORIDA AVE
Practice Address - Street 2:LSUSD ENDODONTICS, ROOM 4312
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70119-2714
Practice Address - Country:US
Practice Address - Phone:504-941-8395
Practice Address - Fax:504-941-8400
Is Sole Proprietor?:No
Enumeration Date:2007-11-29
Last Update Date:2007-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA2214122300000X, 1223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics
No122300000XDental ProvidersDentist