Active NPI
Brandi Hodge, DDS
- Dentist
- Russellville, AR
National Provider Identifier
1689801243
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 3710
- Practice address
- 2112 W Main St
Russellville, AR 72801-2758 - Phone
- (479) 968-7314
- NPI assigned
- Jun 22, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 3710 | AR | Primary |
Addresses
Primary practice location
2112 W Main St
Russellville, AR 72801-2758
Mailing address
2112 W Main St
Russellville, AR 72801-2758
Phone (479) 968-7314
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1245628800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1245628800000",
"number": "1689801243",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2112 W MAIN ST",
"city": "RUSSELLVILLE",
"state": "AR",
"postal_code": "728012758",
"telephone_number": "479-968-7314"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2112 W MAIN ST",
"city": "RUSSELLVILLE",
"state": "AR",
"postal_code": "728012758",
"telephone_number": "479-968-7314"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HODGE",
"first_name": "BRANDI",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-06-22",
"last_updated": "2009-06-22",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "AR",
"license": "3710",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Russellville, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.