Provider Demographics
NPI:1467627794
Name:ARDOIN-KENNEDY, L.L.C.
Entity Type:Organization
Organization Name:ARDOIN-KENNEDY, L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:P
Authorized Official - Last Name:HUGUET
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-948-9878
Mailing Address - Street 1:2351 LARKSPUR LN
Mailing Address - Street 2:
Mailing Address - City:OPELOUSAS
Mailing Address - State:LA
Mailing Address - Zip Code:70570-8664
Mailing Address - Country:US
Mailing Address - Phone:337-948-9878
Mailing Address - Fax:337-948-9097
Practice Address - Street 1:2351 LARKSPUR LN
Practice Address - Street 2:
Practice Address - City:OPELOUSAS
Practice Address - State:LA
Practice Address - Zip Code:70570-8664
Practice Address - Country:US
Practice Address - Phone:337-948-9878
Practice Address - Fax:337-948-9097
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-28
Last Update Date:2008-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA42551223S0112X
LA46251223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1842559Medicaid
LA1846252Medicaid
LA5T8355CS43Medicare PIN
LA5X392Medicare PIN
LA1846252Medicaid
LA5CS43Medicare UPIN
LA5X3925CS43Medicare UPIN
LA1842559Medicaid