NPI 1558282020 · live from the CMS NPI Registry
A Professional Dental Organization
Dentist in Slidell, LA. National Provider Identifier 1558282020, active.
NPI record
| NPI | 1558282020 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Dentist 122300000X |
| Practice location | 2300 Gause Blvd E, Slidell, LA 70461 |
| Practice phone | 985-641-7200 |
| Mailing address | 5830 Granite Pkwy Ste 780, Plano, TX 75024 |
| Enumerated | July 22, 2026 |
| Last updated | July 22, 2026 |
| Authorized official | Erika Menjivar, Sr. Credentialing Specialist |
| Other names | Crossgates Dental |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dentist primary | 122300000X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.