Provider Demographics
NPI:1659124410
Name:LITTLE PEAS PEDIATRIC DENTISTRY, LLC
Entity Type:Organization
Organization Name:LITTLE PEAS PEDIATRIC DENTISTRY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ PEDIATRIC DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:VU
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:504-906-5426
Mailing Address - Street 1:1637 CLEARVIEW PARKWAY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70001-3490
Mailing Address - Country:US
Mailing Address - Phone:504-315-7336
Mailing Address - Fax:
Practice Address - Street 1:1637 CLEARVIEW PARKWAY
Practice Address - Street 2:SUITE 100
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70001-3490
Practice Address - Country:US
Practice Address - Phone:504-315-7336
Practice Address - Fax:504-315-7346
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-10
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty