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Contact Information

SHANE TEWIS, DDS OF LOUISIANA, A PROFESSIONAL DENTAL LLC
2625 DILLARD LOOP
STE A
LAKE CHARLES, LA70607
 Phone: 337-242-1800
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

General Practice

1223G0001X
 

Dentist

122300000X
Indicates primary specialty

NPI Profile & details for SHANE TEWIS, DDS OF LOUISIANA, A PROFESSIONAL DENTAL LLC

NPI # 1023556370
LBN Legal business name SHANE TEWIS, DDS OF LOUISIANA, A PROFESSIONAL DENTAL LLC
Authorized official HALEY WOOSTER - (ENROLLMENT MANAGER)
Entity Organization
Organization subpart 1 No
Enumeration date 02/07/2017
Last updated 04/13/2026 - About 2 months ago
Identifiers
LA License # 6219
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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