Active NPI
Nathan E. Hodges, D.D.S., M.S., P.A.
- Periodontics
- Rockwall, TX
National Provider Identifier
1730239195
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- 20061
- Practice address
- 1010 W Ralph M Hall Pkwy
Ste. 101
Rockwall, TX 75032-6655 - Phone
- (972) 771-8640
- Fax
- (972) 771-8638
- NPI assigned
- Jan 10, 2007
- 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 |
|---|---|---|---|---|
| Periodontics | 1223P0300X | 20061 | TX | Primary |
Addresses
Primary practice location
1010 W Ralph M Hall Pkwy
Ste. 101
Rockwall, TX 75032-6655
Mailing address
1010 W Ralph M Hall Pkwy
Ste. 101
Rockwall, TX 75032-6655
Phone (972) 771-8640
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Sep 24, 2015 through Sep 24, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science, Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Thomas D. Charbeneau, DDS, MSD, PA | Periodontics | Past | Accepting new patients |
| Northeast Texas Periodontal Services | Periodontics | Past | Accepting new patients |
| DRS. Stukalin, P.a. | Periodontics | Past | Accepting new patients |
Organizations & group practices 3
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.
-
- Periodontics
- Paris, TX
- NPI 1912293853
-
- Periodontics
- Dallas, TX
- NPI 1205988441
-
- Periodontics
- Paris, TX
- NPI 1568474989
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": "1183852800000",
"number": "1730239195",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1010 W RALPH M HALL PKWY",
"address_2": "STE. 101",
"city": "ROCKWALL",
"state": "TX",
"postal_code": "750326655",
"telephone_number": "972-771-8640",
"fax_number": "972-771-8638"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1010 W RALPH M HALL PKWY",
"address_2": "STE. 101",
"city": "ROCKWALL",
"state": "TX",
"postal_code": "750326655",
"telephone_number": "972-771-8640",
"fax_number": "972-771-8638"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HODGES",
"first_name": "NATHAN",
"middle_name": "E.",
"name_prefix": "Dr.",
"credential": "D.D.S., M.S., P.A.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-10",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "TX",
"license": "20061",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rockwall, TX
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.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.