Provider Demographics
NPI:1508980269
Name:LUDINGTON, JOHN ROBERT JR (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:ROBERT
Last Name:LUDINGTON
Suffix:JR
Gender:M
Credentials:DDS
Other - Prefix:
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Mailing Address - Street 1:1423 BEACHCOMBER LN
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77062-5404
Mailing Address - Country:US
Mailing Address - Phone:281-480-2553
Mailing Address - Fax:281-480-2553
Practice Address - Street 1:6516 JOHN FREEMAN ST
Practice Address - Street 2:SUITE 202
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-3402
Practice Address - Country:US
Practice Address - Phone:713-500-4227
Practice Address - Fax:713-500-0402
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX134801223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX47557OtherTEXAS DPS
TXD8P045180Medicaid
TXD8P045180Medicaid