Provider Demographics
NPI:1730236597
Name:AUGILLARD, WANDA BIRCH (DDS)
Entity type:Individual
Prefix:DR
First Name:WANDA
Middle Name:BIRCH
Last Name:AUGILLARD
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3711 FRENCHMEN ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70122-3705
Mailing Address - Country:US
Mailing Address - Phone:504-947-7700
Mailing Address - Fax:
Practice Address - Street 1:3711 FRENCHMEN ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70122-3705
Practice Address - Country:US
Practice Address - Phone:504-947-7700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2025-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA46071223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1846074Medicaid