Individual provider Active NPI

E Parker H Cudd Sr., DMD

  • Dentist
  • Augusta, GA
National Provider Identifier
1538215918
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN010018 Issued in GA
Practice address
2431 Peach Orchard Rd
Ste D
Augusta, GA 30906
Phone
(706) 790-6597
Fax
(706) 790-4161
NPI assigned
Jan 26, 2007
Last updated
Jul 8, 2007By the provider in NPPES
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
Dentist 122300000X DN010018 GA Primary

Addresses

Primary practice location

2431 Peach Orchard Rd
Ste D
Augusta, GA 30906

Mailing address

2431 Peach Orchard Rd
Ste D
Augusta, GA 30906
Phone (706) 790-6597

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20260106000193 GA Order and Referring Only - DentistPractitioner - Dentist 7719473123

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN010018GAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1169769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1538215918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2431 PEACH ORCHARD RD",
            "address_2": "STE D",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "30906",
            "telephone_number": "706-790-6597",
            "fax_number": "706-790-4161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2431 PEACH ORCHARD RD",
            "address_2": "STE D",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "30906",
            "telephone_number": "706-790-6597",
            "fax_number": "706-790-4161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUDD",
        "first_name": "E PARKER",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "name_suffix": "Sr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "GA",
            "license": "DN010018",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Augusta, GA

Sources for this page

Verify at the official NPI Registry.