Individual provider Active NPI

Donald R Hodson, DDS

  • Dentist
  • Pomona, CA
National Provider Identifier
1083689665
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
26427 Issued in CA
Practice address
1956 Indian Hill Blvd
Pomona, CA 91767
Phone
(909) 621-5848
Fax
(909) 621-5458
NPI assigned
Feb 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 26427 CA Primary

Addresses

Primary practice location

1956 Indian Hill Blvd
Pomona, CA 91767

Mailing address

1956 Indian Hill Blvd
Pomona, CA 91767
Phone (909) 621-5848

Other identifiers 1

IdentifierTypeStateIssuer
B2642701MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160314000384 CA Order and Referring Only - DentistPractitioner - Dentist 0345546636

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1140134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1083689665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1956 INDIAN HILL BLVD",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "91767",
            "telephone_number": "909-621-5848",
            "fax_number": "909-621-5458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1956 INDIAN HILL BLVD",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "91767",
            "telephone_number": "909-621-5848",
            "fax_number": "909-621-5458"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HODSON",
        "first_name": "DONALD",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-17",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "26427",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "B2642701",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pomona, CA

Sources for this page

Verify at the official NPI Registry.