Individual provider Active NPI

Marc Hodges, DMD

  • Student in an Organized Health Care Education/Training Program
  • Torrance, CA
National Provider Identifier
1124697941
Registry record updated May 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
109947 Issued in CA
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

Updated by the provider on May 24, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

TypeEndpointUseAffiliation
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

LicenseStateTypeSpecialty
11625TNMDDentist
109947CAMDStudent 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.

Verify at the official NPI Registry.