Hudson Guy Motley, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

5564-015 Issued in WI

Practice address

2410 Sampson St
Dental Clinic
Great Lakes, IL 60088-2942

Phone

(847) 688-3620

Fax

(847) 688-6259

NPI assigned

Jan 24, 2006

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

Medicare fee-for-service enrollment

Enrolled in IL

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1138060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1316917370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "378 E RANNEY AVE",
            "city": "VERNON HILLS",
            "state": "IL",
            "postal_code": "600614133",
            "telephone_number": "847-955-9434",
            "fax_number": "847-688-6259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2410 SAMPSON ST",
            "address_2": "DENTAL CLINIC",
            "city": "GREAT LAKES",
            "state": "IL",
            "postal_code": "600882942",
            "telephone_number": "847-688-3620",
            "fax_number": "847-688-6259"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOTLEY",
        "first_name": "HUDSON",
        "middle_name": "GUY",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "5564-015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Milan Mitrovic, PH.D.
• Melanie Marie Fioramonti Mohler, PHARMD
• Peter Andrew Morawiecki, MD
• Eslin Louise Mornay, DDS
• Dinneshia Annetta Moten, DENTAL HYGIENIST
• Maria Mouchaham
• Clifford Loren Moudy II, I.D.C.
• James Patrick Muir, D.D.S.
• Jordan Munar
• John J Murphy, D.D.S.

• General Practice Dentistry in Great Lakes, IL
• Providers in Great Lakes, IL by specialty
• General Practice Dentistry in Illinois

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.