Kenneth Fred Luedtke, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

5000666 Issued in WI

Practice address

4943 W Fond Du Lac Ave
Milwaukee, WI 53216-2324

Phone

(414) 873-3020

NPI assigned

Jun 5, 2008

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1212624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212624000000",
    "number": "1861651655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4943 W FOND DU LAC AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532162324",
            "telephone_number": "414-873-3020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4943 W FOND DU LAC AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532162324",
            "telephone_number": "414-873-3020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUEDTKE",
        "first_name": "KENNETH",
        "middle_name": "FRED",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-06-05",
        "last_updated": "2008-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "5000666",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33534200",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amber L Luecke, DPT
• Jeffrey Luecke, FNP
• Christopher Lueckfeld-Carls, RBT
• Ryan Lueder, PHARM D
• Alexis Marie Luedtke
• Samantha J Lueloff
• Maureen Teresa Luetje, D.O.
• Ericka Lauren Luetschwager, APNP
• Pankaj Luitel, MD
• Marshall Lukacs, MD, PHD

• Dentist in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Dentist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2008; 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.