OrganizationActive
Country Club Dental
NPI 1003970682 · General Practice Dentistry · Baton Rouge, LA
Country Club Dental is a General Practice Dentistry organization in Baton Rouge, LA (NPI 1003970682).
Provider details
- NPI number
- 1003970682
- Entity type
- Organization
- Primary specialty
- General Practice DentistryDental Providers
- Organization subpart
- No
- Authorized official
- Darrell Bourg, Dentist(504) 232-6624
- License
- 5312 (LA)
Specialties & taxonomies
Dental Providers
Profile Score
Detailed profile(90/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
16645 Highland Rd Ste J
Baton Rouge, LA 70810-6567
Phone: (225) 214-0100
Fax: (225) 214-0103
Street-level locationGet directions
Mailing address
16645 Highland Rd Ste J
Baton Rouge, LA 70810-6567
Other names (DBA / former)
- Doing business as
- Louisiana Dental Spa
Registry dates
- Enumerated
- 2006-12-20
- Last updated
- 2020-08-22
Frequently asked questions
- What is Country Club Dental's NPI number?
- Country Club Dental's National Provider Identifier (NPI) is 1003970682, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Country Club Dental?
- Country Club Dental is classified in the NPPES registry as General Practice Dentistry (Dental Providers).
- Where is Country Club Dental located?
- Country Club Dental's practice location on file with NPPES is 16645 Highland Rd Ste J, Baton Rouge, LA 70810-6567.
- What is Country Club Dental's phone number?
- The practice phone number listed in the NPPES registry for Country Club Dental is (225) 214-0100.
- Who is the authorized official for Country Club Dental?
- The authorized official listed on Country Club Dental's NPPES record is Darrell Bourg, Dentist. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Country Club Dental's NPI active?
- Yes — Country Club Dental's NPI (1003970682) is active in the NPPES registry as of the last update on 2020-08-22.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.