Provider Demographics
NPI:1821112210
Name:KIMBERLY D. BESSIX LLC
Entity Type:Organization
Organization Name:KIMBERLY D. BESSIX LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KIMBELRY
Authorized Official - Middle Name:
Authorized Official - Last Name:BESSIX
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:225-625-3251
Mailing Address - Street 1:PO BOX 780
Mailing Address - Street 2:
Mailing Address - City:MARINGOUIN
Mailing Address - State:LA
Mailing Address - Zip Code:70757-0780
Mailing Address - Country:US
Mailing Address - Phone:225-625-3251
Mailing Address - Fax:
Practice Address - Street 1:10530 LIONS AVE.
Practice Address - Street 2:
Practice Address - City:MARINGOUIN
Practice Address - State:LA
Practice Address - Zip Code:70757
Practice Address - Country:US
Practice Address - Phone:225-625-3251
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
Not Answered124Q00000XDental ProvidersDental HygienistGroup - Multi-Specialty