Active NPI
Marc Hodges, DMD
- Student in an Organized Health Care Education/Training Program
- Torrance, CA
National Provider Identifier
1124697941
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- License
- 109947
- Practice address
- 1000 W Carson St
Torrance, CA 90502-2004 - Phone
- (424) 306-4040
- NPI assigned
- Jun 24, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | 109947 | CA | Primary |
| Dentist | 122300000X | 11625 | TN |
Addresses
Primary practice location
1000 W Carson St
Torrance, CA 90502-2004
Mailing address
18229 Amie Ave
Torrance, CA 90504-4602
Phone (619) 709-6969
Other practice location 1
11350 E Des Moines Cir
Mesa, AZ 85207-2367
Phone (619) 709-6969
Other practice location 2
40 Burton Hills Blvd Ste 200
Nashville, TN 37215-5902
Phone (615) 647-5452
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | N/a |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11625 | TN | MD | Dentist |
| 109947 | CA | MD | Student in an Organized Health Care Education/Training Program |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1624492800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1779580800000",
"number": "1124697941",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18229 AMIE AVE",
"city": "TORRANCE",
"state": "CA",
"postal_code": "905044602",
"telephone_number": "619-709-6969"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1000 W CARSON ST",
"city": "TORRANCE",
"state": "CA",
"postal_code": "905022004",
"telephone_number": "424-306-4040"
}
],
"practiceLocations": [
{
"address_1": "11350 E Des Moines Cir",
"address_purpose": "LOCATION",
"city": "Mesa",
"state": "AZ",
"postal_code": "852072367",
"country_code": "US",
"telephone_number": "619-709-6969",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "40 Burton Hills Blvd Ste 200",
"address_purpose": "LOCATION",
"city": "Nashville",
"state": "TN",
"postal_code": "372155902",
"country_code": "US",
"telephone_number": "615-647-5452",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HODGES",
"first_name": "MARC",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-06-24",
"last_updated": "2026-05-24",
"certification_date": "2026-05-24",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "CA",
"license": "109947",
"primary": true
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "TN",
"license": "11625",
"primary": false
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "N/a",
"affiliation": "N",
"address_1": "11350 E Des Moines Cir",
"city": "Mesa",
"state": "AZ",
"country_code": "US",
"postal_code": "852072367",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Torrance, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.