Douglas Eugene Ladue III, D.D.S

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

2901020005 Issued in MI

Practice address

2017 Eastcastle Dr SE
Suite a
Grand Rapids, MI 49508-8872

Phone

(616) 455-4646

NPI assigned

Jun 25, 2009

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: dladue2372840@direct.trinity-health.org

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.

• Smilie'S Pediatric Dentistry

  • Pediatric Dentistry
  • Grand Rapids, MI
  • NPI 1356085930
  NPD (past) Authorized official
• Smilie'S Pediatric Dentistry

  • Pediatric Dentistry
  • Grand Rapids, MI
  • NPI 1821732850
  NPD (past)

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

{
    "created_epoch": "1245888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639526400000",
    "number": "1376771618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2017 EASTCASTLE DR SE",
            "address_2": "SUITE A",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495088872",
            "telephone_number": "616-455-4646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2017 EASTCASTLE DR SE",
            "address_2": "SUITE A",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495088872",
            "telephone_number": "616-455-4646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LADUE",
        "first_name": "DOUGLAS",
        "middle_name": "EUGENE",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-25",
        "last_updated": "2021-12-15",
        "certification_date": "2021-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "MI",
            "license": "2901020005",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901020005",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sharon Lacy, LMSW
• Amber Ladd
• Elizabeth Louise Ladd
• Derek Anthony Lado, DO
• Grace Patricia Ladouceur, BA
• Brian Lafata
• Aubrey Lafave, COTA/L
• Jordan Lafave, D.O.
• Margaux Lafave, LMSW
• Laurie Lafeldt, OTR

• Pediatric Dentistry in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Pediatric Dentistry in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2021; 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.