Active NPI
Robert Hideo Judy, DDS
- Orthodontics and Dentofacial Orthopedics Dentistry
- Travis Afb, CA
National Provider Identifier
1477534915
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- 19584
- Practice address
- 101 Bodin Cir
Travis Afb, CA 94535-1809 - Phone
- (707) 423-7052
- NPI assigned
- Nov 10, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 19584 | TX | Primary |
Addresses
Primary practice location
101 Bodin Cir
Travis Afb, CA 94535-1809
Mailing address
1006 Freshwater CT
Vacaville, CA 95687-7910
Phone (707) 446-2124
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 19584 | TX | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1131580800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1477534915",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1006 FRESHWATER CT",
"city": "VACAVILLE",
"state": "CA",
"postal_code": "956877910",
"telephone_number": "707-446-2124"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 BODIN CIR",
"city": "TRAVIS AFB",
"state": "CA",
"postal_code": "945351809",
"telephone_number": "707-423-7052"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JUDY",
"first_name": "ROBERT",
"middle_name": "HIDEO",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-11-10",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "TX",
"license": "19584",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Travis Afb, CA
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.