Provider Demographics
NPI:1336585025
Name:BABIN, RANDALL JOSEPH JR (DDS)
Entity Type:Individual
Prefix:DR
First Name:RANDALL
Middle Name:JOSEPH
Last Name:BABIN
Suffix:JR
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 1:10631 HILLARY CT
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70810-2842
Mailing Address - Country:US
Mailing Address - Phone:225-590-3835
Mailing Address - Fax:225-590-3836
Practice Address - Street 1:10631 HILLARY CT
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70810-2842
Practice Address - Country:US
Practice Address - Phone:225-590-3835
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-21
Last Update Date:2023-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA63551223G0001X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice