Michael James Judi, DMD
Individual provider Active NPI General Practice Dentistry · Monticello, UT
NPI 1982701322 · NPPES record last updated Nov 30, 2010
Key facts
- NPI
- 1982701322
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 9921 (UT)
- Practice address
- 365 S North Creek Lane
Monticello, UT 84535-0756 - Phone
- (580) 574-7699
- NPI assigned
- Sep 20, 2006
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8413 | KY | MD | Dentist |
| 9921 | UT | MD | General Practice Dentistry |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 8413 | KY | |
| General Practice Dentistry | 1223G0001X | 9921 | UT | Yes |
Addresses
Primary practice location
365 S North Creek Lane
Monticello, UT 84535-0756
Mailing address
PO Box 756
Monticello, UT 84535-0756
Phone (580) 574-7699
Other providers in Monticello, UT
- Blen Arlow Freestone
- Paul Goodrich
- Brian James Goodwine
- Ihc Health Services Inc
- Kelly Marvin Jeppesen
- Kayenta Dental
- Dylan Naylor Knight
- Kade Shumway Lyman
- Main Street Drug & Boutique, Inc.
- Main Street Pharmacare LLC
All providers in Monticello, UT · General Practice Dentistry in Utah
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 30, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.