Individual provider Active NPI

Amanda Hudson, D.M.D

  • Dentist
  • Birmingham, AL
National Provider Identifier
1659721819
Registry record updated Jun 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
6306 Issued in AL
Practice address
2320 7TH Ave S
Birmingham, AL 35233-3207
Phone
(205) 251-1010
NPI assigned
Jun 20, 2016
Last updated
Jun 20, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 6306 AL Primary

Addresses

Primary practice location

2320 7TH Ave S
Birmingham, AL 35233-3207

Mailing address

2100 1St Ave N
Suite 300
Birmingham, AL 35203-4213
Phone (205) 623-4455

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20170927002950 AL Order and Referring Only - DentistPractitioner - Dentist 7618241720

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Alabama Health, LLC Dentist Past Accepting new patients
Alabama Health Dentist Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1466380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466380800000",
    "number": "1659721819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 1ST AVE N",
            "address_2": "SUITE 300",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352034213",
            "telephone_number": "205-623-4455",
            "fax_number": "205-415-1398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2320 7TH AVE S",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352333207",
            "telephone_number": "205-251-1010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUDSON",
        "first_name": "AMANDA",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-20",
        "last_updated": "2016-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AL",
            "license": "6306",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, AL

Sources for this page

Verify at the official NPI Registry.