DR. SUSAN PRATER KUDLATS DMD
NPI 1689803041
Dentist in Jacksonville, FL

Q: What is Susan Prater Kudlats's NPI number?

The NPI number for Susan Prater Kudlats is 1689803041. It was assigned to this individual provider in the NPPES registry on July 7, 2009. The provider is also known as Dr. Susan Prater Dmd.

Q: What is Susan Prater Kudlats's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Q: Is Susan Prater Kudlats enrolled in Medicare?

No. Susan Prater Kudlats has opted out of Medicare through January 21, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

Active since July 07, 2009Opted out of Medicare · through Jan 21, 2028

12620 BEACH BLVD, SUITE 18, JACKSONVILLE, FL 32246(706) 738-6516(706) 262-6518 Get Directions Write a Review

NPPES record last updated: March 25, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Dr. Susan Prater Kudlats Dmd NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. SUSAN PRATER KUDLATS DMD (NPI 1689803041) is an individual dentist in Jacksonville, Florida, licensed in Florida (DN21768) and active in the NPI registry since July 2009. She has opted out of Medicare through January 21, 2028.

NPPES Registry Identity

NPI1689803041

Entity TypeIndividualFemale

Primary Taxonomy122300000X

Provider Legal NameDR. SUSAN PRATER KUDLATSCredential: DMD

Location Address12620 BEACH BLVD, SUITE 18Jacksonville, FL 32246

Mailing Address221 Spanish Creek DrivePonte Vedra, FL 32081 · (706) 738-6516 · Fax (706) 262-6518

Phone(706) 738-6516

Fax(706) 262-6518

Sole ProprietorNo

Enumeration DateJuly 7, 2009

Last NPPES UpdateMarch 25, 2024

✔ NPI 1689803041 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers

Taxonomy Code122300000X

License✔ Licensed in FL · DN21768

Definition

A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

12620 BEACH BLVD, Jacksonville, FL 32246

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Other Names 1

Former Name (1)Dr. Susan Prater Dmd

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Dr. Susan Prater Kudlats Dmd has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from January 21, 2016 through January 21, 2028.

Opt-Out Effective DateJanuary 21, 2016

Opt-Out In Effect ThroughJanuary 21, 2028Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES 16

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MS. MEGAN MICHELLE FADIL PHARM D

Pharmacist

12620 BEACH BLVD, SUITE 12
JACKSONVILLE, FL 32246

Duval County (904) 564-3586

DR. AARON JOHN PLOESSL D.C.

Chiropractor

12620 BEACH BLVD, SUITE 6
JACKSONVILLE, FL 32246

Duval County (904) 645-0777

DR. SEAN FRANCIS MCHUGH D.C.

Chiropractor

12620 BEACH BLVD, SUITE 6
JACKSONVILLE, FL 32246

Duval County (904) 645-0777

DR. DEBORAH FRALICKER DC

Nurse Practitioner (Family)

12620 BEACH BLVD, SUITE 6
JACKSONVILLE, FL 32246

Duval County (904) 645-0777

DR. IRINA EUGENIEVNA BOLDT M.D.

Family Medicine

12620 BEACH BLVD
JACKSONVILLE, FL 32246

Duval County (904) 633-0585

DR. DAVID RICHARD OLINZOCK D.D.S.

Dentist (General Practice)

12620 BEACH BLVD, STE 18
JACKSONVILLE, FL 32246

Duval County (904) 620-0404

QUALICARE HEALTH INC

Home Health

12620 BEACH BLVD, 143
JACKSONVILLE, FL 32246

Duval County (904) 827-9099

DIANNE CHANDLER PHARM D

Pharmacist

12620 BEACH BLVD
JACKSONVILLE, FL 32246

Duval County (904) 564-3586

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Susan Prater Kudlats's NPI number?

The NPI number for Susan Prater Kudlats is 1689803041. It was assigned to this individual provider in the NPPES registry on July 7, 2009. The provider is also known as Dr. Susan Prater Dmd.

Where is Susan Prater Kudlats located?

Susan Prater Kudlats practices at 12620 Beach Blvd Suite 18, Jacksonville, FL 32246. The listed phone number is (706) 738-6516.

What is Susan Prater Kudlats's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Is Susan Prater Kudlats enrolled in Medicare?

No. Susan Prater Kudlats has opted out of Medicare through January 21, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

What insurance does Susan Prater Kudlats accept?

Health plans from Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and Blue Cross and Blue Shield of Texas list Susan Prater Kudlats as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Susan Prater Kudlats was last updated on March 25, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.