Individual provider Active NPI

Michelle A Ludwick, DDS

  • Dentist
  • Yuma, AZ
National Provider Identifier
1699741371
Registry record updated Jun 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D010999 Issued in AZ
Practice address
7949 E 24TH St
Yuma, AZ 85365-8602
Phone
(928) 317-1900
NPI assigned
Feb 23, 2006
Last updated
Jun 16, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 16, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X D7345 OR
Dentist 122300000X D010999 AZ Primary

Addresses

Primary practice location

7949 E 24TH St
Yuma, AZ 85365-8602

Mailing address

7949 E 24TH St
Yuma, AZ 85365-8602
Phone (928) 317-1900

Other identifiers 1

IdentifierTypeStateIssuer
D010999OtherAZDENTAL LICENSE

Other names 1

  • Dr. Michelle Angela Ludwick Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20150713001015 OR Order and Referring Only - DentistPractitioner - Dentist 9638481112

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D010999AZMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Garner Thorson Dental, PLLC CurrentSince May 1, 2022 Accepting new patients
Gila Family Dental LLC CurrentSince May 1, 2022 Accepting new patients

Locations

7949 E 24th St
Yuma, AZ 85365
Phone (928) 249-3673

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": "1140652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655337600000",
    "number": "1699741371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7949 E 24TH ST",
            "city": "YUMA",
            "state": "AZ",
            "postal_code": "853658602",
            "telephone_number": "928-317-1900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7949 E 24TH ST",
            "city": "YUMA",
            "state": "AZ",
            "postal_code": "853658602",
            "telephone_number": "928-317-1900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUDWICK",
        "first_name": "MICHELLE",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-02-23",
        "last_updated": "2022-06-16",
        "certification_date": "2022-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OR",
            "license": "D7345",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AZ",
            "license": "D010999",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTAL LICENSE",
            "identifier": "D010999",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHELLE",
            "last_name": "LUDWICK",
            "middle_name": "ANGELA",
            "prefix": "DR.",
            "credential": "DDS",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Yuma, AZ

Sources for this page

Verify at the official NPI Registry.