Individual provider Active NPI

Robert E Hudock, D.M.D.

  • General Practice Dentistry
  • Monroeville, PA
National Provider Identifier
1699855650
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DS029676L Issued in PA
Practice address
320 Center Rd
Monroeville, PA 15146-1322
Phone
(412) 372-5100
Fax
(412) 372-1931
NPI assigned
Oct 16, 2006
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
General Practice Dentistry 1223G0001X DS029676L PA Primary

Addresses

Primary practice location

320 Center Rd
Monroeville, PA 15146-1322

Mailing address

193 Congruity Rd
Greensburg, PA 15601-8472
Phone (724) 668-8703

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

State licenses

LicenseStateTypeSpecialty
DS029676LPAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Western Pennsylvania Dental Group General Practice PastSince Jul 31, 2023 Accepting new patients
Western Pennsylvania Dental Group General Practice 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1699855650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "193 CONGRUITY RD",
            "city": "GREENSBURG",
            "state": "PA",
            "postal_code": "156018472",
            "telephone_number": "724-668-8703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 CENTER RD",
            "city": "MONROEVILLE",
            "state": "PA",
            "postal_code": "151461322",
            "telephone_number": "412-372-5100",
            "fax_number": "412-372-1931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUDOCK",
        "first_name": "ROBERT",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS029676L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroeville, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.