NPIMap

Organization Active NPI

Philip N. Hodge, DDS, PS

  • Dentist
  • Renton, WA
National Provider Identifier
1619320900
Registry record updated Jul 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DE 00004936 Issued in WA
Legal business name
PHILIP N. HODGE, DDS, PS
Practice address
19221 108TH Ave SE Ste 4
Renton, WA 98055-7369
Phone
(253) 852-4746
Fax
(253) 852-4754
NPI assigned
Jul 21, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2016

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

Authorized official

Name
Dr. Philip Norman Hodge, D.D.S.NPI 1538234513
Title
Owner/General Dentist
Phone
(253) 852-4746

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X DE 00004936 WA Primary

Addresses

Primary practice location

19221 108TH Ave SE Ste 4
Renton, WA 98055-7369

Mailing address

19221 108TH Ave SE Ste 4
Renton, WA 98055-7369
Phone (253) 852-4746

National Provider Directory

National Provider Directory

Locations

19221 108th Ave SE
Ste 4
Renton, WA 98055
Phone (253) 852-4746

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1469059200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1469059200000",
    "number": "1619320900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19221 108TH AVE SE STE 4",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980557369",
            "telephone_number": "253-852-4746",
            "fax_number": "253-852-4754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19221 108TH AVE SE STE 4",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980557369",
            "telephone_number": "253-852-4746",
            "fax_number": "253-852-4754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHILIP N. HODGE, DDS, PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-21",
        "last_updated": "2016-07-21",
        "status": "A",
        "authorized_official_last_name": "HODGE",
        "authorized_official_first_name": "PHILIP",
        "authorized_official_middle_name": "NORMAN",
        "authorized_official_title_or_position": "OWNER/GENERAL DENTIST",
        "authorized_official_telephone_number": "253-852-4746",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE 00004936",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Renton, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2016; 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.