Jonathan Stewart Judd, DDS

Primary specialty

Public Health DentistryTaxonomy code 1223D0001X

License

DE00009360 Issued in WA

Practice address

1004 S. Monroe Street
Spokane, WA 99204

Phone

(509) 838-5597

Fax

(509) 838-7195

NPI assigned

May 23, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in ID

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1148342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621900800000",
    "number": "1831144310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1004 S. MONROE STREET",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "99204",
            "telephone_number": "509-838-5597",
            "fax_number": "509-838-7195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1004 S. MONROE STREET",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "99204",
            "telephone_number": "509-838-5597",
            "fax_number": "509-838-7195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUDD",
        "first_name": "JONATHAN",
        "middle_name": "STEWART",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-23",
        "last_updated": "2021-05-25",
        "certification_date": "2021-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223D0001X",
            "taxonomy_group": "",
            "desc": "Dentist, Dental Public Health",
            "state": "WA",
            "license": "DE00009360",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5048467",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Oliver Grayson Juaire
• Kristina Jubinville, CDP
• Leslie Dwain Judah, PA-C
• Corey Derek Judd, M.D.
• Debra J Judd, R.N., ARNP
• Joseph A Judd, MS
• Michael A Judd, M.D.
• Judy Felgenhauer, M.D., P.S.
• Judy Thornton MSW PLLC
• Steven N. Jukich, D.C.

• Public Health Dentistry in Spokane, WA
• Providers in Spokane, WA by specialty
• Public Health Dentistry in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.