Individual provider Active NPI

Kenneth A Budke, DDS

  • Dentist
  • Cedar Falls, IA
National Provider Identifier
1457410326
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
05833 Issued in IA
Practice address
3217 Cedar Heights Drive
Cedar Falls, IA 50613
Phone
(319) 277-6921
Fax
(319) 859-2007
NPI assigned
Dec 7, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 05833 IA Primary

Addresses

Primary practice location

3217 Cedar Heights Drive
Cedar Falls, IA 50613

Mailing address

3217 Cedar Heights Drive
Cedar Falls, IA 50613
Phone (319) 277-6921

Other identifiers 1

IdentifierTypeStateIssuer
0005975MedicaidIA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Kimball and Beecher PLLC Past Accepting new patients
Amy Hartmann Eye Care, LLC PastSince Jul 20, 2020 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1165449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1457410326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3217 CEDAR HEIGHTS DRIVE",
            "city": "CEDAR FALLS",
            "state": "IA",
            "postal_code": "50613",
            "telephone_number": "319-277-6921",
            "fax_number": "319-859-2007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3217 CEDAR HEIGHTS DRIVE",
            "city": "CEDAR FALLS",
            "state": "IA",
            "postal_code": "50613",
            "telephone_number": "319-277-6921",
            "fax_number": "319-859-2007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUDKE",
        "first_name": "KENNETH",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IA",
            "license": "05833",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0005975",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedar Falls, IA

Sources for this page

  • 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.