Provider Demographics
NPI:1134345994
Name:OLIVIER, BRIAN JUDE (DDS)
Entity type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:JUDE
Last Name:OLIVIER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3116 6TH ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70002-1729
Mailing Address - Country:US
Mailing Address - Phone:504-218-7300
Mailing Address - Fax:504-218-7302
Practice Address - Street 1:3116 6TH ST
Practice Address - Street 2:SUITE 202
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70002-1729
Practice Address - Country:US
Practice Address - Phone:504-218-7300
Practice Address - Fax:504-218-7302
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-18
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA54211223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1854212Medicaid