Individual provider Active NPI

Kayla Doreen Judd, DDS

  • General Practice Dentistry
  • Connersville, IN
National Provider Identifier
1598658007
Registry record updated Jun 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
12014747A Issued in IN
Practice address
2628 Western Ave
Connersville, IN 47331-1803
Phone
(765) 825-2941
Fax
(765) 827-5796
NPI assigned
Jun 2, 2025
Last updated
Jun 2, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2025

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 12014747A IN Primary

Addresses

Primary practice location

2628 Western Ave
Connersville, IN 47331-1803

Mailing address

2628 Western Ave
Connersville, IN 47331-1803
Phone (765) 825-2941

Other names 1

  • Miss Kayla Doreen Burch Former name

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
12014747AINMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Christie Family Dentistry General Practice PastSince Jun 8, 2025 Accepting new patients
Dr. Tom Christie Family Dentistry PC PastSince Jun 8, 2025 Accepting new patients

Organizations & group practices 2

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": "1748822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748822400000",
    "number": "1598658007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2628 WESTERN AVE",
            "city": "CONNERSVILLE",
            "state": "IN",
            "postal_code": "473311803",
            "telephone_number": "765-825-2941",
            "fax_number": "765-827-5796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2628 WESTERN AVE",
            "city": "CONNERSVILLE",
            "state": "IN",
            "postal_code": "473311803",
            "telephone_number": "765-825-2941",
            "fax_number": "765-827-5796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUDD",
        "first_name": "KAYLA",
        "middle_name": "DOREEN",
        "name_prefix": "Mrs.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-02",
        "last_updated": "2025-06-02",
        "certification_date": "2025-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12014747A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAYLA",
            "last_name": "BURCH",
            "middle_name": "DOREEN",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Connersville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2025; 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.