Basic Information
| Provider Information | |||||||||
| NPI: | 1497788368 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DONGIEUX | ||||||||
| FirstName: | JEFFREY | ||||||||
| MiddleName: | WALKER | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | D.D.S. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1900 W. ESPLANADE AVE. | ||||||||
| Address2: | STE 101 | ||||||||
| City: | KENNER | ||||||||
| State: | LA | ||||||||
| PostalCode: | 70065 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5044688300 | ||||||||
| FaxNumber: | 5044688307 | ||||||||
| Practice Location | |||||||||
| Address1: | 8330 LONG POINT RD | ||||||||
| Address2: | |||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770552023 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7134614770 | ||||||||
| FaxNumber: | 7134610998 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/07/2006 | ||||||||
| LastUpdateDate: | 09/12/2013 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1223P0106X | 22969 | TX | N | Dental Providers | Dentist | Oral and Maxillofacial Pathology | 1223S0112X | 5529 | LA | Y | Dental Providers | Dentist | Oral and Maxillofacial Surgery |
No ID Information.