Dibenedetto, Jeffery L.
Dibenedetto, Jeffery L. is an individual health care provider with primary practice located at 2290 S Range Ave , Denham Springs LA 70726-5214. He recently has 3 registered licenses in different health care specialties including Eye and Vision Services Providers / Optometrist, Eye and Vision Services Providers / Sports Vision, Eye and Vision Services Providers / Corneal and Contact Management. Eye and Vision Services Providers / Optometrist is his primary health care specialty. Dibenedetto, Jeffery L. can be contacted via phone (225) 665-2019.Contact Information
Primary practice address
2290 S Range Ave
Denham Springs LA 70726-5214
Phone: (225) 665-2019
Fax: (225) 665-2089
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 1321-456T | Louisiana |
| Eye and Vision Services Providers / Sports Vision | 152WS0006X | 1321-456T | Louisiana |
| Eye and Vision Services Providers / Corneal and Contact Management | 152WC0802X | 1321-456T | Louisiana |
Profile Details
| NPI number | 1255360525 |
|---|---|
| LBN Legal business name | Dibenedetto, Jeffery L. |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 30th, 2006 |
| Last updated | Jan 27th, 2012 - about 12 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1255360525 | NPPES |
| Louisiana | MEDICAID | 1105350 |
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