Heather Judd, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

4196-015 Issued in WI

Practice address

12033 Agency Rd
Parker, AZ 85344-7718

Phone

(928) 669-3154

NPI assigned

Sep 14, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1158192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1164527974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3015 DAYTONA AVE",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864035445",
            "telephone_number": "928-855-8373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12033 AGENCY RD",
            "city": "PARKER",
            "state": "AZ",
            "postal_code": "853447718",
            "telephone_number": "928-669-3154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUDD",
        "first_name": "HEATHER",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "4196-015",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "918344",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John E McClellan
• Merle Leo Johnson, LISAC
• Shannon Moore Johnson, LISAC, BA
• Brianna Lee Jones
• Lemuel Jones
• James W Kearns, RN
• Kristine J Keel, RN
• Julia Keller
• Dawn Aileen Kelly, O.D.
• Kevin S. Klopfenstein M.D. P.C.

• Dentist in Parker, AZ
• Providers in Parker, AZ by specialty
• Dentist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.