NPIMap

Organization Active NPI

Kim Thomas Judice, DDS Family Dentistry

  • General Practice Dentistry
  • Lafayette, LA
National Provider Identifier
1669500195
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
3422 Issued in LA
Legal business name
KIM THOMAS JUDICE, DDS FAMILY DENTISTRY
Practice address
111 Noel Dr
Lafayette, LA 70503
Phone
(337) 988-0020
Fax
(337) 988-0244
NPI assigned
Feb 28, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Kim Thomas Judice, DDSNPI 1215073473
Title
Owner
Phone
(337) 988-0020

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 3422 LA Primary

Addresses

Primary practice location

111 Noel Dr
Lafayette, LA 70503

Mailing address

111 Noel Dr
Lafayette, LA 70503
Phone (337) 988-0020

Other identifiers 1

IdentifierTypeStateIssuer
1881805MedicaidLA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1669500195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 NOEL DR",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "70503",
            "telephone_number": "337-988-0020",
            "fax_number": "337-988-0244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 NOEL DR",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "70503",
            "telephone_number": "337-988-0020",
            "fax_number": "337-988-0244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIM THOMAS JUDICE, DDS FAMILY DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JUDICE",
        "authorized_official_first_name": "KIM",
        "authorized_official_middle_name": "THOMAS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "337-988-0020",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "LA",
            "license": "3422",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1881805",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.