Gray Hodge, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

4184 Issued in AR

Practice address

501 N 6TH St
Blytheville, AR 72315-2407

Phone

(870) 763-2100

Fax

(870) 762-5383

NPI assigned

Jun 23, 2017

Last updated

Jun 23, 2017By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Hodge Dental, PLLC

  dba Hodge Dental

  • Dental Clinic/Center
  • Blytheville, AR
  • NPI 1881114478
  NPD (past) Authorized official
• James a Hess DDS

  • General Practice Dentistry
  • Blytheville, AR
  • NPI 1982805768
  NPD (past)

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

{
    "created_epoch": "1498176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1498176000000",
    "number": "1255851846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1805 MARILYN DR",
            "city": "CARUTHERSVLLE",
            "state": "MO",
            "postal_code": "638302349",
            "telephone_number": "870-623-0040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 N 6TH ST",
            "city": "BLYTHEVILLE",
            "state": "AR",
            "postal_code": "723152407",
            "telephone_number": "870-763-2100",
            "fax_number": "870-762-5383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HODGE",
        "first_name": "GRAY",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-23",
        "last_updated": "2017-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AR",
            "license": "4184",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARKANSAS DENTAL LICENSE",
            "identifier": "4184",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MISSOURI DENTAL LICENSE",
            "identifier": "2017013084",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Higginbotham Dental Group, PLLC (Higginbotham Family Dental)
• Michael T Higginbotham, DDS
• Shamana Brook Hill
• Hodge Dental, PLLC (Hodge Dental)
• Chase Winston Hodge, DMD
• Cryshana Hodges
• Josh Hodges, NP-C
• Bethany Holcomb, COTA
• Bridget Holleman, AA MHPP
• Constance Hollis, RN

• General Practice Dentistry in Blytheville, AR
• Providers in Blytheville, AR by specialty
• General Practice Dentistry in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2017; 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.