Judd Ellis Partridge, D.M.D.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

D-3980 Issued in ID

Practice address

4775 W Daybreak Pkwy Ste 104
South Jordan, UT 84009-5139

Phone

(801) 280-5535

Fax

(801) 987-3601

NPI assigned

Dec 21, 2006

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Sep 20, 2019 through Sep 20, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Judd E Partridge DMD LLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Salt Lake City, UT
  • NPI 1043615156
  NPD (past) Authorized official

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

{
    "created_epoch": "1166659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714435200000",
    "number": "1588728646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4775 W DAYBREAK PKWY STE 104",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "840095139",
            "telephone_number": "801-280-5535",
            "fax_number": "801-987-3601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4775 W DAYBREAK PKWY STE 104",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "840095139",
            "telephone_number": "801-280-5535",
            "fax_number": "801-987-3601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARTRIDGE",
        "first_name": "JUDD",
        "middle_name": "ELLIS",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-21",
        "last_updated": "2024-04-30",
        "certification_date": "2024-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "ID",
            "license": "D-3980",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashlyn Park
• Jennifer Lynne Parker, LCSW
• Ivery Parkinson
• Sarah Peighton Parkinson
• Milena Parra
• Tiffany Murillo Paskett, ACMHC
• Ana Patricia Pastor, FNP
• Hemant Parsottamdas Patel
• Shetu Rakesh Patel
• Tina Patel

• Oral and Maxillofacial Surgery (Dentist) in South Jordan, UT
• Providers in South Jordan, UT by specialty
• Oral and Maxillofacial Surgery (Dentist) in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2024; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.