Active NPI
Quinton Lee Hedgepeth, DDS
- Dentist
- Port St Lucie, FL
National Provider Identifier
1720004278
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 8096
- Practice address
- 1100 SW Saint Lucie West Blvd
Suite 206
Port St Lucie, FL 34986-1780 - Phone
- (772) 607-1223
- NPI assigned
- Jul 15, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 | 8096 | FL | Primary |
Addresses
Primary practice location
1100 SW Saint Lucie West Blvd
Suite 206
Port St Lucie, FL 34986-1780
Mailing address
1100 SW Saint Lucie West Blvd
Suite 206
Port St Lucie, FL 34986-1780
Phone (772) 607-1223
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8096 | FL | MD | Speech-Language Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152921600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1251331200000",
"number": "1720004278",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1100 SW SAINT LUCIE WEST BLVD",
"address_2": "SUITE 206",
"city": "PORT ST LUCIE",
"state": "FL",
"postal_code": "349861780",
"telephone_number": "772-607-1223"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1100 SW SAINT LUCIE WEST BLVD",
"address_2": "SUITE 206",
"city": "PORT ST LUCIE",
"state": "FL",
"postal_code": "349861780",
"telephone_number": "772-607-1223"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HEDGEPETH",
"first_name": "QUINTON",
"middle_name": "LEE",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-15",
"last_updated": "2009-08-27",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "FL",
"license": "8096",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Port St Lucie, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 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.