Individual provider Active NPI

Dorothy Lou Hudley, HYGIENIST

  • Dental Hygienist
  • Fort Moore, GA
National Provider Identifier
1316789258
Registry record updated Jun 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental HygienistTaxonomy code 124Q00000X
License
H.007162 Issued in AL
Practice address
7101 Hoff St
Fort Moore, GA 31905-5645
Phone
(706) 544-4795
NPI assigned
Jun 11, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental HygienistGroup: 193400000X SINGLE SPECIALTY GROUP 124Q00000X H.007162 AL Primary

Addresses

Primary practice location

7101 Hoff St
Fort Moore, GA 31905-5645

Mailing address

7101 Hoff St
Fort Moore, GA 31905-5645
Phone (706) 544-4795

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
H.007162ALMDDental Hygienist

NPI Registry JSON

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

{
    "created_epoch": "1718064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718064000000",
    "number": "1316789258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7101 HOFF ST",
            "city": "FORT MOORE",
            "state": "GA",
            "postal_code": "319055645",
            "telephone_number": "706-544-4795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7101 HOFF ST",
            "city": "FORT MOORE",
            "state": "GA",
            "postal_code": "319055645",
            "telephone_number": "706-544-4795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUDLEY",
        "first_name": "DOROTHY",
        "middle_name": "LOU",
        "credential": "HYGIENIST",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-06-11",
        "last_updated": "2024-06-11",
        "certification_date": "2024-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dental Hygienist",
            "state": "AL",
            "license": "H.007162",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Moore, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2024; 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.