Provider Demographics
NPI:1487775078
Name:SCHEXNAYDER, RAYMOND J (DDS)
Entity type:Individual
Prefix:
First Name:RAYMOND
Middle Name:J
Last Name:SCHEXNAYDER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1429 CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:JEANERETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70544-4432
Mailing Address - Country:US
Mailing Address - Phone:337-276-4111
Mailing Address - Fax:337-276-4111
Practice Address - Street 1:1429 CHURCH ST
Practice Address - Street 2:
Practice Address - City:JEANERETTE
Practice Address - State:LA
Practice Address - Zip Code:70544-4432
Practice Address - Country:US
Practice Address - Phone:337-276-4111
Practice Address - Fax:337-276-4111
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA21581223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1821586Medicaid