Provider Demographics
NPI:1659401966
Name:VINCI ORAL & FACIAL SURGERY INC
Entity Type:Organization
Organization Name:VINCI ORAL & FACIAL SURGERY INC
Other - Org Name:BAKER K VINCI
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BAKER
Authorized Official - Middle Name:K
Authorized Official - Last Name:VINCI
Authorized Official - Suffix:
Authorized Official - Credentials:ORAL SURGEON
Authorized Official - Phone:225-923-3223
Mailing Address - Street 1:7225 JEFFERSON HWY
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70806
Mailing Address - Country:US
Mailing Address - Phone:225-923-3223
Mailing Address - Fax:225-923-3511
Practice Address - Street 1:7225 JEFFERSON HWY
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70806
Practice Address - Country:US
Practice Address - Phone:225-923-3223
Practice Address - Fax:225-923-3511
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LALA47421223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1847429Medicaid
LA1847429Medicaid
U57361Medicare UPIN