Individual provider Active NPI

Karol Ludena, DDS

  • General Practice Dentistry
  • Shoreline, WA
National Provider Identifier
1558932020
Registry record updated Jul 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
61157493 Issued in WA
Practice address
735 N 185TH St
Shoreline, WA 98133-3901
Phone
(206) 542-7000
NPI assigned
Jul 6, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 61157493 WA Primary

Addresses

Primary practice location

735 N 185TH St
Shoreline, WA 98133-3901

Mailing address

420 Pontius Ave N Apt 318
Seattle, WA 98109-5839
Phone (206) 446-2354

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

LicenseStateTypeSpecialty
61157493WAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Tommy Fong, DDS, Vivian M. Bennett, DDS, PC General Practice PastSince Jul 17, 2021 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1625529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625616000000",
    "number": "1558932020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 PONTIUS AVE N APT 318",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981095839",
            "telephone_number": "206-446-2354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "735 N 185TH ST",
            "city": "SHORELINE",
            "state": "WA",
            "postal_code": "981333901",
            "telephone_number": "206-542-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUDENA",
        "first_name": "KAROL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-06",
        "last_updated": "2021-07-07",
        "certification_date": "2021-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "61157493",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shoreline, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 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.