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

Jerardy Ivan Velasquez-Bravo

Individual provider Dental Assistant · NPI 1861311573

Jerardy Ivan Velasquez-Bravo is a Dental Assistant in Fort Polk, Louisiana. Licensed in Louisiana. Registered with an NPI since 2026.

Licensed in
LA
In the registry since
2026

Practice location Address checks out

6180 University Pkwy Unit 3905
Fort Polk, LA 71459-3118
Phone: (757) 709-5503
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dental Assistant (primary) Taxonomy 126800000X (LA)

Record details

NPI number1861311573
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJuly 15, 2026
Last updated in NPPESJuly 15, 2026
Certification dateJuly 15, 2026
Mailing address6180 University Pkwy Unit 3905, Fort Polk, LA 71459-3118

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