Provider Demographics
NPI:1457589806
Name:LAUDIE, JOSEPH AMMON (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:AMMON
Last Name:LAUDIE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2510 W VIEW DR
Mailing Address - Street 2:
Mailing Address - City:EMPORIA
Mailing Address - State:KS
Mailing Address - Zip Code:66801-5980
Mailing Address - Country:US
Mailing Address - Phone:913-980-8304
Mailing Address - Fax:
Practice Address - Street 1:2516 W 15TH AVE
Practice Address - Street 2:
Practice Address - City:EMPORIA
Practice Address - State:KS
Practice Address - Zip Code:66801-6102
Practice Address - Country:US
Practice Address - Phone:620-342-8032
Practice Address - Fax:620-342-5735
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-24
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPENDING122300000X
KS606931223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist