NPI 1255360525

Jeffery L. Dibenedetto, OD

Practitioner Optometrist Denham Springs, LA

Practice location

Address: 2290 S Range Ave, Denham Springs, LA 70726-5214
Phone: (225) 665-2019
Fax: (225) 665-2089

Registered specialties (3)

Optometrist Primary

Eye and Vision Services Providers Taxonomy 152W00000X Licence 1321-456T (LA)

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Eye and Vision Services Providers Taxonomy 152WS0006X Licence 1321-456T (LA)

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Eye and Vision Services Providers Taxonomy 152WC0802X Licence 1321-456T (LA)

Registry record

NPI: 1255360525
Entity type: Individual
Sex (as registered): Male
NPI issued: 30 Jun 2006
Record last updated: 27 Jan 2012

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.