Active NPI
Scott Cameron Hudson, D.D.S.
- General Practice Dentistry
- Acworth, GA
National Provider Identifier
1720137490
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- DN015726
- Practice address
- 3509 Baker Rd NW Ste 401
Acworth, GA 30101-6305 - Phone
- (770) 917-8943
- NPI assigned
- Jan 10, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 31127 | CA | |
| General Practice Dentistry | 1223G0001X | DN015726 | GA | Primary |
Addresses
Primary practice location
3509 Baker Rd NW Ste 401
Acworth, GA 30101-6305
Mailing address
158 Victoria Sta
Woodstock, GA 30189-1467
Phone (760) 867-6866
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | docsspot1953@gmail.com | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200908001104 | FL | Order and Referring Only - Dentist | 5597183582 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 31127 | CA | MD | Clinical Psychologist |
| DN015726 | GA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168387200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1597708800000",
"number": "1720137490",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "158 VICTORIA STA",
"city": "WOODSTOCK",
"state": "GA",
"postal_code": "301891467",
"telephone_number": "760-867-6866"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3509 BAKER RD NW STE 401",
"city": "ACWORTH",
"state": "GA",
"postal_code": "301016305",
"telephone_number": "770-917-8943"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HUDSON",
"first_name": "SCOTT",
"middle_name": "CAMERON",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-10",
"last_updated": "2020-08-18",
"certification_date": "2020-08-18",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "31127",
"primary": false
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "GA",
"license": "DN015726",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "docsspot1953@gmail.com",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "3509 Baker Rd NW Ste 401",
"city": "Acworth",
"state": "GA",
"country_code": "US",
"postal_code": "301016305",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Acworth, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2020; 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.