Provider Demographics
NPI:1164215745
Name:MAGEE, ALYSSA
Entity type:Individual
Prefix:DR
First Name:ALYSSA
Middle Name:
Last Name:MAGEE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 BISCAYNE LN
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70508-8096
Mailing Address - Country:US
Mailing Address - Phone:337-344-7014
Mailing Address - Fax:
Practice Address - Street 1:117 HECTOR CONNOLY RD STE 2
Practice Address - Street 2:
Practice Address - City:CARENCRO
Practice Address - State:LA
Practice Address - Zip Code:70520-6351
Practice Address - Country:US
Practice Address - Phone:337-565-2580
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-27
Last Update Date:2025-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA7675122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist