NPIMap

Organization Active NPI

Judd Dentistry PA

  • General Practice Dentistry
  • Columbia, MD
National Provider Identifier
1679629828
Registry record updated Aug 30, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
13389 Issued in MD
Legal business name
JUDD DENTISTRY PA
Practice address
8860 Columbia 100 Pkwy
Suite 106
Columbia, MD 21045-2195
Phone
(410) 884-5833
Fax
(410) 884-5836
NPI assigned
Jan 27, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2016

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

Authorized official

Name
Dr. Keisha Patrice Bruney Judd, D.M.D
Title
Owner
Phone
(410) 884-5833

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 13389 MD Primary

Addresses

Primary practice location

8860 Columbia 100 Pkwy
Suite 106
Columbia, MD 21045-2195

Mailing address

8860 Columbia 100 Pkwy
Suite 106
Columbia, MD 21045-2195
Phone (410) 884-5833

National Provider Directory

National Provider Directory

Locations

8860 Columbia 100 Pkwy
Ste 106
Columbia, MD 21045
Phone (410) 884-5833

Practitioners & affiliated clinicians

Practitioners 2

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": "1169856000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1472515200000",
    "number": "1679629828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8860 COLUMBIA 100 PKWY",
            "address_2": "SUITE 106",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210452195",
            "telephone_number": "410-884-5833",
            "fax_number": "410-884-5836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8860 COLUMBIA 100 PKWY",
            "address_2": "SUITE 106",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210452195",
            "telephone_number": "410-884-5833",
            "fax_number": "410-884-5836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JUDD DENTISTRY PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-27",
        "last_updated": "2016-08-30",
        "status": "A",
        "authorized_official_last_name": "JUDD",
        "authorized_official_first_name": "KEISHA",
        "authorized_official_middle_name": "PATRICE BRUNEY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "410-884-5833",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "MD",
            "license": "13389",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2016; 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.