David Matthew Ude, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

D13112 Issued in MN

Practice address

14213 Golf Course Rd
#100
Baxter, MN 56425-8432

Phone

(218) 829-4511

NPI assigned

Apr 17, 2012

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

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 and National Provider Directory roles.

• Lakes Dental Care PLC

  • General Practice Dentistry
  • Baxter, MN
  • NPI 1609889302
  NPD (past)

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

{
    "created_epoch": "1334620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1338336000000",
    "number": "1083971915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11700 WOOD DR SW",
            "city": "BRAINERD",
            "state": "MN",
            "postal_code": "564012386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14213 GOLF COURSE RD",
            "address_2": "#100",
            "city": "BAXTER",
            "state": "MN",
            "postal_code": "564258432",
            "telephone_number": "218-829-4511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UDE",
        "first_name": "DAVID",
        "middle_name": "MATTHEW",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-04-17",
        "last_updated": "2012-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "D13112",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kearra Trunde
• Bao Hoang Truong, DDS
• Shayna Lynn Tsinnie
• Jayden Taylor Tuorila, MHP
• Twwmad LLC
• Stephen Vagle, LMFT
• Heidi Van Eps, MASSAGE THERAPIST
• Emily Van Kampen, MS
• Madeline Rose Varland, DDS
• Dawn Elda Varney

• Dentist in Baxter, MN
• Providers in Baxter, MN by specialty
• Dentist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2012; 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.