Individual provider Active NPI

Judith Theomat Eugene, DDS

  • General Practice Dentistry
  • Washington, DC
National Provider Identifier
1609154855
Registry record updated Nov 30, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DEN1001135 Issued in DC
Practice address
1500 Galen St SE
Washington, DC 20020-4936
Phone
(202) 610-7160
Fax
(202) 610-7164
NPI assigned
Jul 21, 2011
Last updated
Nov 30, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2016

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 DEN1001135 DC Primary

Addresses

Primary practice location

1500 Galen St SE
Washington, DC 20020-4936

Mailing address

2250 Champlain Street SW
Washington, DC 20009-2618
Phone (202) 232-9022

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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
I20181211000261 DC Order and Referring Only - DentistPractitioner - Dentist 7214271782

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DEN1001135DCMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1311206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480464000000",
    "number": "1609154855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2250 CHAMPLAIN STREET SW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200092618",
            "telephone_number": "202-232-9022",
            "fax_number": "202-232-8494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 GALEN ST SE",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200204936",
            "telephone_number": "202-610-7160",
            "fax_number": "202-610-7164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EUGENE",
        "first_name": "JUDITH",
        "middle_name": "THEOMAT",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-21",
        "last_updated": "2016-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "DC",
            "license": "DEN1001135",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

Verify at the official NPI Registry.