Kevin Edward Hudson, D.D.S., R.N.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

DENT.DE.00009590 Issued in WA

Practice address

6351 W Rio Grande Ave
Kennewick, WA 99336-7634

Phone

(509) 579-5830

NPI assigned

Aug 26, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Aug 28, 2015 through Aug 28, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1125014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784073600000",
    "number": "1275526972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 190",
            "city": "TOPPENISH",
            "state": "WA",
            "postal_code": "989480190",
            "telephone_number": "509-865-2395",
            "fax_number": "509-865-0757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6351 W RIO GRANDE AVE",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993367634",
            "telephone_number": "509-579-5830"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1112 S Cushman Ave",
            "address_purpose": "LOCATION",
            "city": "Tacoma",
            "state": "WA",
            "postal_code": "984053631",
            "country_code": "US",
            "telephone_number": "253-280-9770",
            "fax_number": "253-246-6822",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4207 Tieton Dr",
            "address_purpose": "LOCATION",
            "city": "Yakima",
            "state": "WA",
            "postal_code": "989083347",
            "country_code": "US",
            "telephone_number": "509-965-8911",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HUDSON",
        "first_name": "KEVIN",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "D.D.S., R.N.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-26",
        "last_updated": "2026-07-15",
        "certification_date": "2026-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "WA",
            "license": "DENT.DE.00009590",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2349719",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Etienne Howery
• Chaianne Chere Hrebeniuk
• Tila Lizann Hubrecht, RN
• Nicole D. Huck, RN
• Jessica Jane Maureen Hudson, LMP
• Robin Hudson
• Jennifer Huff
• Shelby Leigh Huffaker, PTA
• Hughes Physical Therapy, P.S.
• Abigail Hughes

• Oral and Maxillofacial Surgery (Dentist) in Kennewick, WA
• Providers in Kennewick, WA by specialty
• Oral and Maxillofacial Surgery (Dentist) in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.