Organization Active NPI

Robert G Hodous DDS LTD

  • General Practice Dentistry
  • Fayetteville, AR
National Provider Identifier
1366655078
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
3251 Issued in AR
Legal business name
ROBERT G HODOUS DDS LTD
Practice address
2630 E Citizens Dr
Suite 8
Fayetteville, AR 72703-4797
Phone
(479) 582-1100
Fax
(479) 587-1171
NPI assigned
May 8, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mrs. Rhonda A Liles
Title
Patient Coordinator
Phone
(479) 582-1100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 3251 AR Primary

Addresses

Primary practice location

2630 E Citizens Dr
Suite 8
Fayetteville, AR 72703-4797

Mailing address

2630 E Citizens Dr
Suite 8
Fayetteville, AR 72703-4797
Phone (479) 582-1100

National Provider Directory

National Provider Directory

Locations

2630 E Citizens Dr
Ste 8
Fayetteville, AR 72703
Phone (479) 409-5097

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1178582400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1366655078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2630 E CITIZENS DR",
            "address_2": "SUITE 8",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727034797",
            "telephone_number": "479-582-1100",
            "fax_number": "479-587-1171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2630 E CITIZENS DR",
            "address_2": "SUITE 8",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727034797",
            "telephone_number": "479-582-1100",
            "fax_number": "479-587-1171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT G HODOUS DDS LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LILES",
        "authorized_official_first_name": "RHONDA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PATIENT COORDINATOR",
        "authorized_official_telephone_number": "479-582-1100",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AR",
            "license": "3251",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.