Individual provider Active NPI

John A Hudec, DDS

  • General Practice Dentistry
  • Cleveland, OH
National Provider Identifier
1295754240
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
30015265 Issued in OH
Practice address
3329 Broadview Road
Cleveland, OH 44109-3315
Phone
(216) 398-8900
Fax
(216) 741-3131
NPI assigned
Jul 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 30015265 OH Primary

Addresses

Primary practice location

3329 Broadview Road
Cleveland, OH 44109-3315

Mailing address

3329 Broadview Road
Cleveland, OH 44109-3315
Phone (216) 398-8900

Other identifiers 1

IdentifierTypeStateIssuer
0308456MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151125000539 OH Order and Referring Only - DentistPractitioner - Dentist 0749580611

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
30015265OHMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Hudec Dental Center of Canton, Inc. General Practice Past Accepting new patients
John a Hudec DDS Specialty Services Inc General Practice Past Accepting new patients
Hudec Dental Associates, Inc. General Practice Past Accepting new patients
John a Hudec DDS Inc General Practice Past Accepting new patients
John a Hudec Cleveland Dental Health Center Inc General Practice Past Accepting new patients
Hudec Dental Center of Mentor, Inc. General Practice Past Accepting new patients
John a Hudec Puritas Dental Associates Inc General Practice Past Accepting new patients
John a Hudec Strongsville Dental Associates Inc General Practice Past Accepting new patients

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1295754240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3329 BROADVIEW ROAD",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441093315",
            "telephone_number": "216-398-8900",
            "fax_number": "216-741-3131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3329 BROADVIEW ROAD",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441093315",
            "telephone_number": "216-398-8900",
            "fax_number": "216-741-3131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUDEC",
        "first_name": "JOHN",
        "middle_name": "A",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30015265",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0308456",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

Verify at the official NPI Registry.