Active NPI
Thomas Solomon Hodge, DDS
- Dentist
- Saint Cloud, MN
National Provider Identifier
1144899782
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- D14595
- Practice address
- 2860 W Division St Ste 102
Saint Cloud, MN 56301-7330 - Phone
- (320) 200-9011
- NPI assigned
- Jun 18, 2021
- Last updated
- Jun 18, 2021
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | D14595 | MN | Primary |
Addresses
Primary practice location
2860 W Division St Ste 102
Saint Cloud, MN 56301-7330
Mailing address
906 Cypress Rd Apt 215
Saint Cloud, MN 56303-1425
Phone (218) 269-6374
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 |
|---|---|---|---|
| D14595 | MN | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kahn Dental PLLC | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1623974400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1623974400000",
"number": "1144899782",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "906 CYPRESS RD APT 215",
"city": "SAINT CLOUD",
"state": "MN",
"postal_code": "563031425",
"telephone_number": "218-269-6374"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2860 W DIVISION ST STE 102",
"city": "SAINT CLOUD",
"state": "MN",
"postal_code": "563017330",
"telephone_number": "320-200-9011"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HODGE",
"first_name": "THOMAS",
"middle_name": "SOLOMON",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-06-18",
"last_updated": "2021-06-18",
"certification_date": "2021-06-18",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MN",
"license": "D14595",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Cloud, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.