Active NPI
David S Hudson, DMD
- Oral and Maxillofacial Surgery (Dentist)
- Aiken, SC
National Provider Identifier
1215018726
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Oral and Maxillofacial Surgery (Dentist)
- License
- 2183
- Practice address
- 1845 Huntsman Rd
Aiken, SC 29803 - Phone
- (803) 649-1177
- Fax
- (803) 643-2080
- NPI assigned
- Oct 18, 2006
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Oral and Maxillofacial Surgery (Dentist) | 1223S0112X | 2183 | SC | Primary |
Addresses
Primary practice location
1845 Huntsman Rd
Aiken, SC 29803
Mailing address
1845 Huntsman Dr
Aiken, SC 29803-5635
Phone (803) 649-7627
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 110017 | Medicaid | SC |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2183 | SC | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161129600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1215018726",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1845 HUNTSMAN DR",
"city": "AIKEN",
"state": "SC",
"postal_code": "298035635",
"telephone_number": "803-649-7627",
"fax_number": "803-643-2080"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1845 HUNTSMAN RD",
"city": "AIKEN",
"state": "SC",
"postal_code": "29803",
"telephone_number": "803-649-1177",
"fax_number": "803-643-2080"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HUDSON",
"first_name": "DAVID",
"middle_name": "S",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-18",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223S0112X",
"taxonomy_group": "",
"desc": "Dentist, Oral and Maxillofacial Surgery",
"state": "SC",
"license": "2183",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "110017",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Aiken, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.