FERN AVENUE DENTISTRY, LLC
NPI 1447469069
Dentist - General Practice in Shreveport, LA

Q: What is Fern Avenue Dentistry, LLC's NPI number?

The NPI number for Fern Avenue Dentistry, LLC is 1447469069. It was assigned to this organization in the NPPES registry on May 21, 2007.

Q: What is Fern Avenue Dentistry, LLC's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Active since May 21, 2007

8535 FERN AVE # 2, SHREVEPORT, LA 71105(318) 798-3376(318) 798-3310 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Fern Avenue Dentistry, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

FERN AVENUE DENTISTRY, LLC (NPI 1447469069) is a healthcare organization registered as a general practice in Shreveport, Louisiana and active in the NPI registry since May 2007. The organization lists Brian Kennedy Broadwell, Dentist, Owner, as its authorized official.

NPPES Registry Identity

NPI1447469069

Entity TypeOrganization

Primary Taxonomy1223G0001X

Legal Business NameFERN AVENUE DENTISTRY, LLC

Location Address8535 FERN AVE # 2Shreveport, LA 71105-5656

Mailing Address8535 Fern Ave # 2Shreveport, LA 71105-5656 · (318) 798-3376 · Fax (318) 798-3310

Phone(318) 798-3376

Fax(318) 798-3310

Organization SubpartNo

Authorized OfficialBrian Kennedy BroadwellDentist, Owner · (318) 798-3376

Enumeration DateMay 21, 2007

Last NPPES UpdateAugust 22, 2020

✔ NPI 1447469069 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers

Taxonomy Code1223G0001X

License✔ Licensed in LA · 5313

Definition

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

8535 FERN AVE # 2, Shreveport, LA 71105

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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Fern Avenue Dentistry, LLC's NPI number?

The NPI number for Fern Avenue Dentistry, LLC is 1447469069. It was assigned to this organization in the NPPES registry on May 21, 2007.

Where is Fern Avenue Dentistry, LLC located?

Fern Avenue Dentistry, LLC is located at 8535 Fern Ave # 2, Shreveport, LA 71105. The listed phone number is (318) 798-3376.

What is Fern Avenue Dentistry, LLC's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

When was this NPI record last updated?

The NPPES record for Fern Avenue Dentistry, LLC was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.