Provider Demographics
NPI:1083720114
Name:SCHMIDT, JUDITH KAY (DDS)
Entity Type:Individual
Prefix:DR
First Name:JUDITH
Middle Name:KAY
Last Name:SCHMIDT
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 36
Mailing Address - Street 2:
Mailing Address - City:WAHPETON
Mailing Address - State:ND
Mailing Address - Zip Code:58074-0036
Mailing Address - Country:US
Mailing Address - Phone:701-640-7656
Mailing Address - Fax:
Practice Address - Street 1:2005 WOODLAND DRIVE
Practice Address - Street 2:
Practice Address - City:WAHPETON
Practice Address - State:ND
Practice Address - Zip Code:58075
Practice Address - Country:US
Practice Address - Phone:701-672-9595
Practice Address - Fax:701-672-9599
Is Sole Proprietor?:No
Enumeration Date:2006-08-22
Last Update Date:2017-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND1995122300000X
MND123091223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice