Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Shreveport Periodontal Specialists

Organization Periodontics · NPI 1720803356

Shreveport Periodontal Specialists is a Periodontics in Shreveport, Louisiana. Registered with an NPI since 2024.

In the registry since
2024

Practice location Address checks out

745 Edgemont St
Shreveport, LA 71106-2246
Phone: (318) 868-0535
Fax: (318) 868-0572
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Periodontics (primary) Taxonomy 1223P0300X

Record details

NPI number1720803356
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Angela Watson — Coo · (318) 868-0535
NPI enumeratedNovember 19, 2024
Last updated in NPPESNovember 19, 2024
Certification dateNovember 19, 2024
Mailing address745 Edgemont St, Shreveport, LA 71106-2246

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