Provider Demographics
NPI:1982966255
Name:LUDWIG, KEVIN HARRINGTON (DDS)
Entity Type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:HARRINGTON
Last Name:LUDWIG
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:10211 DUPONT CIRCLE DR W
Mailing Address - Street 2:SUITE B
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46825-1622
Mailing Address - Country:US
Mailing Address - Phone:260-490-5437
Mailing Address - Fax:
Practice Address - Street 1:10211 DUPONT CIRCLE DR W
Practice Address - Street 2:SUITE B
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46825-1622
Practice Address - Country:US
Practice Address - Phone:260-490-5437
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-13
Last Update Date:2017-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12011802A1223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry