Active NPI
Kevin Harrington Ludwig, D.D.S.
- Pediatric Dentistry
- Fort Wayne, IN
National Provider Identifier
1982966255
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 12011802A
- Practice address
- 10211 Dupont Circle Dr W
Suite B
Fort Wayne, IN 46825-1622 - Phone
- (260) 490-5437
- NPI assigned
- Jun 13, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 12011802A | IN | Primary |
Addresses
Primary practice location
10211 Dupont Circle Dr W
Suite B
Fort Wayne, IN 46825-1622
Mailing address
10211 Dupont Circle Dr W
Suite B
Fort Wayne, IN 46825-1622
Phone (260) 490-5437
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12011802A | IN | MD | Pediatric Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1339545600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1484092800000",
"number": "1982966255",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10211 DUPONT CIRCLE DR W",
"address_2": "SUITE B",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468251622",
"telephone_number": "260-490-5437"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10211 DUPONT CIRCLE DR W",
"address_2": "SUITE B",
"city": "FORT WAYNE",
"state": "IN",
"postal_code": "468251622",
"telephone_number": "260-490-5437"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUDWIG",
"first_name": "KEVIN",
"middle_name": "HARRINGTON",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-06-13",
"last_updated": "2017-01-11",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "IN",
"license": "12011802A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Wayne, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.