Provider Demographics
NPI:1356456073
Name:HESTER, KEVIN J (DDS)
Entity type:Individual
Prefix:
First Name:KEVIN
Middle Name:J
Last Name:HESTER
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 1:2576 TOULON DRIVE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816
Mailing Address - Country:US
Mailing Address - Phone:225-292-8270
Mailing Address - Fax:225-291-8271
Practice Address - Street 1:2576 TOULON DRIVE
Practice Address - Street 2:SUITE 1
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70816
Practice Address - Country:US
Practice Address - Phone:225-292-8270
Practice Address - Fax:225-291-8271
Is Sole Proprietor?:No
Enumeration Date:2006-08-20
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA39701223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
LAF1428OtherBCBS
LA1839701Medicaid
970918OtherUNITED CONCORDIA
LA1839701Medicaid
970918OtherUNITED CONCORDIA