Thomas P Judd, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

12011153A Issued in IN

Practice address

1901 #B Western Avenue
Ihc South Bend
South Bend, IN 46601

Phone

(574) 234-9033

Fax

(574) 234-9059

NPI assigned

Jul 10, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

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

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

{
    "created_epoch": "1215648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1215648000000",
    "number": "1952565772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1901 #B WESTERN AVENUE",
            "address_2": "IHC SOUTH BEND",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "46601",
            "telephone_number": "574-234-9033",
            "fax_number": "574-234-9059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 #B WESTERN AVENUE",
            "address_2": "IHC SOUTH BEND",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "46601",
            "telephone_number": "574-234-9033",
            "fax_number": "574-234-9059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUDD",
        "first_name": "THOMAS",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-10",
        "last_updated": "2008-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IN",
            "license": "12011153A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patricia Ann Jordan, MD
• Toriyona Jordan, RBT
• Abigail Jorgensen, CD-L(PRODOULA)
• Joseph W Cochran DDS PC
• Jennifer Lee Joyce
• Jill R Judge, LCSW
• Franklin Julian
• Julie a Wieger DPM PC
• Roger William Jump III, D.O.
• Alexis Jurkowski

• Dentist in South Bend, IN
• Providers in South Bend, IN by specialty
• Dentist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2008; 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.