Individual provider Active NPI

John Andrew Hodges, D.D.S. P.S.

  • General Practice Dentistry
  • Covington, WA
National Provider Identifier
1124159538
Registry record updated Oct 31, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DE00007813 Issued in WA
Practice address
27015 169TH PL SE
# 100
Covington, WA 98042-5574
Phone
(425) 224-2452
Fax
(425) 224-2760
NPI assigned
Mar 8, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DE00007813 WA Primary

Addresses

Primary practice location

27015 169TH PL SE
# 100
Covington, WA 98042-5574

Mailing address

27015 169TH PL SE
# 100
Covington, WA 98042-5574
Phone (425) 224-2452

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20160425000322 WA Order and Referring Only - DentistPractitioner - Dentist 5698717528

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Daniel H Chong DDS PS Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1173312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477872000000",
    "number": "1124159538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27015 169TH PL SE",
            "address_2": "# 100",
            "city": "COVINGTON",
            "state": "WA",
            "postal_code": "980425574",
            "telephone_number": "425-224-2452",
            "fax_number": "425-224-2760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27015 169TH PL SE",
            "address_2": "# 100",
            "city": "COVINGTON",
            "state": "WA",
            "postal_code": "980425574",
            "telephone_number": "425-224-2452",
            "fax_number": "425-224-2760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HODGES",
        "first_name": "JOHN",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "D.D.S. P.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-08",
        "last_updated": "2016-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE00007813",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Covington, WA

Sources for this page

Verify at the official NPI Registry.