Russell Arbrey Hulse, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DS8165 Issued in TN

Practice address

1212 N Kentucky St
Kingston, TN 37763-2328

Phone

(865) 717-3586

NPI assigned

Oct 13, 2005

Sex

Male

Sole proprietor

No

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.

• Kingston Dental LLC

  • General Practice Dentistry
  • Kingston, TN
  • NPI 1083860498

  General Practice

  NPD (past)
• Nwaloshin Dental PLLC

  • General Practice Dentistry
  • Kingston, TN
  • NPI 1831688258

  General Practice

  NPD (past)

Medicare fee-for-service enrollment

Enrolled in TN

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 16, 2012.

{
    "created_epoch": "1129161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1345075200000",
    "number": "1700875671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1203 OLD N KENTUCKY ST",
            "city": "KINGSTON",
            "state": "TN",
            "postal_code": "377632358",
            "telephone_number": "865-717-3586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1212 N KENTUCKY ST",
            "city": "KINGSTON",
            "state": "TN",
            "postal_code": "377632328",
            "telephone_number": "865-717-3586"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HULSE",
        "first_name": "RUSSELL",
        "middle_name": "ARBREY",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-13",
        "last_updated": "2012-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TN",
            "license": "DS8165",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5440252",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Summer Renee' Houchin
• Jacqueline E Howard, N.P.
• Susan Faye Howell
• HS Holdings LLC
• Evon Elizabeth Hulse, DDS
• Humphreys Family Holdings
• Brantley Humphreys, RN-BSN
• Linda G Hunter, DC
• Independent Physical Therapy LLC
• Farzana Sharmin Iqbal, M.D.

• All providers in Kingston, TN
• General Practice Dentistry in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.