Provider Demographics
NPI:1144377516
Name:LOYOLA, JAMES ANTHONY (DMD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:ANTHONY
Last Name:LOYOLA
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4902 CANAL ST
Mailing Address - Street 2:STE. 401
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70119-5840
Mailing Address - Country:US
Mailing Address - Phone:504-484-7246
Mailing Address - Fax:504-488-0061
Practice Address - Street 1:4902 CANAL ST
Practice Address - Street 2:STE. 401
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70119-5840
Practice Address - Country:US
Practice Address - Phone:504-484-7246
Practice Address - Fax:504-488-0061
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-05
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA41431223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1841439Medicaid