Brandon Ladoux, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DE 60214111 Issued in WA

Practice address

100 N Tribal Center Rd
Skokomish Nation, WA 98584-9748

Phone

(360) 426-5755

NPI assigned

Jun 3, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1307059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325721600000",
    "number": "1558655886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N TRIBAL CENTER RD",
            "city": "SKOKOMISH NATION",
            "state": "WA",
            "postal_code": "985849748",
            "telephone_number": "360-426-5755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 N TRIBAL CENTER RD",
            "city": "SKOKOMISH NATION",
            "state": "WA",
            "postal_code": "985849748",
            "telephone_number": "360-426-5755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LADOUX",
        "first_name": "BRANDON",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-03",
        "last_updated": "2012-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE 60214111",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tiffany Eklund
• Kirk P Fowler, SUDP
• Michelle Gordon, MSW
• Amber Hanson
• Bille Sue Hodge
• Katherine Lindley, ARNP, FNP-BC
• Virginia M Lujan, DDS
• Kim B Miker, DNP
• Julie Ann Powers, CDP
• Alexander Creighton Runnette II, MA,LMHC

• General Practice Dentistry in Skokomish Nation, WA
• Providers in Skokomish Nation, WA by specialty
• General Practice Dentistry in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.