Jacobi Lazar Ludwig, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

63228 Issued in CA

Practice address

1905 Plaza Dr
Eagan, MN 55122-2883

Phone

(651) 686-6678

Fax

(805) 529-0102

NPI assigned

Dec 8, 2006

Last updated

Oct 7, 2014By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• JLL Dental Inc

  • Dentist
  • Moorpark, CA
  • NPI 1285037002
  NPD (past) Authorized official
• Northland Dental Partners

  dba Metro Dentalcare

  • General Practice Dentistry
  • Eagan, MN
  • NPI 1770730954
  NPD (past)
• Ely Hasany DDS,Inc.

  • Dentist
  • Moorpark, CA
  • NPI 1013345834
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1165536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412640000000",
    "number": "1043370414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "217 W LOS ANGELES AVE",
            "city": "MOORPARK",
            "state": "CA",
            "postal_code": "930211867",
            "telephone_number": "805-529-0100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1905 PLAZA DR",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551222883",
            "telephone_number": "651-686-6678",
            "fax_number": "805-529-0102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUDWIG",
        "first_name": "JACOBI",
        "middle_name": "LAZAR",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-08",
        "last_updated": "2014-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D12085",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "63228",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "78420600",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Natalie Losurdo
• Lotus Counseling Center
• Sophia Lowe
• Lrha Transportation LLC
• Thomas Luby
• Robert David Lukin, D.C.
• Kelley Lumbard, DC
• Jayna Lundgren
• Steven Jay Lusch, O.D.
• Jonathan Dale Lutz

• General Practice Dentistry in Eagan, MN
• Providers in Eagan, MN by specialty
• General Practice Dentistry in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.