Judis Alumcreek Dental

Primary specialty

DentistTaxonomy code 122300000X

License

19680 Issued in OH

Legal business name

JUDIS ALUMCREEK DENTAL

Practice address

4016 Alum Creek Dr
Columbus, OH 43207-5137

Phone

(614) 409-9404

Fax

(614) 409-2992

NPI assigned

Sep 13, 2011

Organization subpart

No

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

Authorized official

Name

Gary M Judis, DDS

Title

Owner

Phone

(614) 409-9404

Specialties & licenses 2

Addresses

Other identifiers 2

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

{
    "created_epoch": "1315872000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1315872000000",
    "number": "1093097495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4016 ALUM CREEK DR",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432075137",
            "telephone_number": "614-409-9404",
            "fax_number": "614-409-2992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4016 ALUM CREEK DR",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432075137",
            "telephone_number": "614-409-9404",
            "fax_number": "614-409-2992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JUDIS ALUMCREEK DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-13",
        "last_updated": "2011-09-13",
        "status": "A",
        "authorized_official_last_name": "JUDIS",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "614-409-9404",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "OH",
            "license": "19680",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "OH",
            "license": "022588",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2039305",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2940894",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Peggy Judd - Massie
• Adam Judd
• Carla Marie Jude, LPN
• Yvonne Judge
• Judis Alum Creek Dental Care
• Sydney Nicole Judkins
• Ashley Judson, RD
• Chelsea Anne Judson, LPC
• Monique Christine Judy, CNP
• Patricia Juergens, RD

• Dentist in Columbus, OH
• Providers in Columbus, OH by specialty
• Dentist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.