S. Clint Hudson, D.M.D., M.D., L.L.C.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

5051 Issued in AL

Legal business name

S. CLINT HUDSON, D.M.D., M.D., L.L.C.

Doing business as

S. Clint Hudson, D.M.D., M.D.

Practice address

2317 Whitesburg Dr S
Huntsville, AL 35801-3819

Phone

(256) 533-1282

Fax

(256) 533-1288

NPI assigned

Jul 14, 2006

Last updated

Sep 3, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

S Clint Hudson, DMD, MD

Title

Owner

Phone

(256) 533-1282

Specialties & licenses 1

Addresses

Other identifiers 6

Other names 1

• S. Clint Hudson, D.M.D., M.D. Doing business as

Medicare fee-for-service enrollment

Enrolled in AL

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Steven Clint Hudson, DMD, MD

  • Oral and Maxillofacial Surgery (Dentist)
  • Huntsville, AL
  • NPI 1629033824
  Medicare reassignment NPD
• Gary W Hudson, D.M.D., M.D.

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Huntsville, AL
  • NPI 1447214424

  Oral and Maxillofacial Surgery

  NPD (past)

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

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1378166400000",
    "number": "1164448320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2317 WHITESBURG DR S",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358013819",
            "telephone_number": "256-533-1282",
            "fax_number": "256-533-1288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2317 WHITESBURG DR S",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358013819",
            "telephone_number": "256-533-1282",
            "fax_number": "256-533-1288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "S. CLINT HUDSON, D.M.D., M.D., L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-14",
        "last_updated": "2013-09-03",
        "status": "A",
        "authorized_official_last_name": "HUDSON",
        "authorized_official_first_name": "S",
        "authorized_official_middle_name": "CLINT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "256-533-1282",
        "authorized_official_credential": "DMD, MD"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "AL",
            "license": "5051",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "K919",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUESHIELD AL",
            "identifier": "51136356",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "529928780",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "001858654",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUESHIELD TN",
            "identifier": "4129232",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUESHIELD AL",
            "identifier": "51003400",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "S. Clint Hudson, D.M.D., M.D.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Michael Ingle Ryan
• Jennifer Ryder, NP-C
• Marlin Sean Ryder, CRNA
• Jessica Ryes
• Elizabeth T Rymer, DPT
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• Jason Sabio

• Oral and Maxillofacial Surgery (Dentist) in Huntsville, AL
• Providers in Huntsville, AL by specialty
• Oral and Maxillofacial Surgery (Dentist) in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.