1. Home
  2. Directory
  3. Louisiana
  4. Arcadia
  5. Dentist
  6. NPI Profile

SOUTHERN PINES DENTAL, LLC
NPI 1922457175
Dentist - General Practice in Arcadia, LA

Active since June 08, 2016
1416 HAZEL ST, ARCADIA, LA 71001(318) 855-1426(318) 579-5038 Get Directions Write a Review

NPPES record last updated: June 8, 2016. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Southern Pines Dental, Llc NPPES

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

SOUTHERN PINES DENTAL, LLC (NPI 1922457175) is a healthcare organization registered as a general practice in Arcadia, Louisiana and active in the NPI registry since June 2016. The organization lists Jesse Roberts, Owner/dentist, as its authorized official.

NPPES Registry Identity

NPI1922457175
Entity TypeOrganization
Primary Taxonomy1223G0001X
Legal Business NameSOUTHERN PINES DENTAL, LLC
Location Address1416 HAZEL STArcadia, LA 71001-4114
Mailing Address1416 Hazel St.Arcadia, LA 71001 · (318) 855-1426 · Fax (318) 579-5038
Phone(318) 855-1426
Fax(318) 579-5038
Organization SubpartNo
Authorized OfficialJesse RobertsOwner/dentist · (318) 855-1426
Enumeration DateJune 8, 2016
✔ NPI 1922457175 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
Licenses✔ Licensed in LA · 3586✔ Licensed in LA · 6627
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.
1416 HAZEL ST, Arcadia, LA 71001
Open in Google Maps ↗

Other Identifiers 2

Medicaid32635LA
Medicaid1835862LA

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 MULTIPLE SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. KYLE GRESHAM DDS
Dentist (General Practice)
1416 HAZEL ST
ARCADIA, LA 71001
Bienville Parish (318) 855-1426
SPD LLC
Clinic/Center (Dental)
1416 HAZEL ST
ARCADIA, LA 71001
Bienville Parish (318) 855-1426
MINDI J ROBERSON
Dentist
1416 HAZEL ST
ARCADIA, LA 71001
Bienville Parish (318) 855-1426

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 Southern Pines Dental, LLC's NPI number?

The NPI number for Southern Pines Dental, LLC is 1922457175. It was assigned to this organization in the NPPES registry on June 8, 2016.

Where is Southern Pines Dental, LLC located?

Southern Pines Dental, LLC is located at 1416 Hazel St, Arcadia, LA 71001. The listed phone number is (318) 855-1426.

What is Southern Pines Dental, 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 Southern Pines Dental, LLC was last updated on June 8, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.