Individual provider Active NPI

Thomas Nelson Ludlow, DDS

  • Dentist
  • Folsom, CA
National Provider Identifier
1578767604
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
47638 Issued in CA
Practice address
1001 E Bidwell Street
Suite 101
Folsom, CA 95630
Phone
(916) 983-6767
Fax
(916) 983-8668
NPI assigned
Jun 13, 2007
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 47638 CA Primary

Addresses

Primary practice location

1001 E Bidwell Street
Suite 101
Folsom, CA 95630

Mailing address

1001 E Bidwell Street
Suite 101
Folsom, CA 95630
Phone (916) 983-6767

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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

Enrollment IDStateProvider typePAC IDDetails
I20150730012110 CA Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 1355519802

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
47638CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Thomas N. Ludlow D.D.S., Inc. PastSince May 6, 2011 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, 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": "1181692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1578767604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 E BIDWELL STREET",
            "address_2": "SUITE 101",
            "city": "FOLSOM",
            "state": "CA",
            "postal_code": "95630",
            "telephone_number": "916-983-6767",
            "fax_number": "916-983-8668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 E BIDWELL STREET",
            "address_2": "SUITE 101",
            "city": "FOLSOM",
            "state": "CA",
            "postal_code": "95630",
            "telephone_number": "916-983-6767",
            "fax_number": "916-983-8668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUDLOW",
        "first_name": "THOMAS",
        "middle_name": "NELSON",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "47638",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Folsom, CA

Sources for this page

Verify at the official NPI Registry.