Active NPI
Clifton Arthur Hodges, DDS
- General Practice Dentistry
- Portland, ME
National Provider Identifier
1730345752
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- DE60022541
- Practice address
- 612 Brighton Avenue
Portland, ME 04102 - Phone
- (207) 772-4359
- Fax
- (207) 772-4990
- NPI assigned
- Jul 29, 2008
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DE60022541 | WA | Primary |
Addresses
Primary practice location
612 Brighton Avenue
Portland, ME 04102
Mailing address
23 Lounder Drive
West Bath, ME 04530
Phone (207) 720-0997
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
| License | State | Type | Specialty |
|---|---|---|---|
| DE60022541 | WA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1217289600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1594339200000",
"number": "1730345752",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "23 LOUNDER DRIVE",
"city": "WEST BATH",
"state": "ME",
"postal_code": "04530",
"telephone_number": "207-720-0997",
"fax_number": "360-330-9580"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "612 BRIGHTON AVENUE",
"city": "PORTLAND",
"state": "ME",
"postal_code": "04102",
"telephone_number": "207-772-4359",
"fax_number": "207-772-4990"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HODGES",
"first_name": "CLIFTON",
"middle_name": "ARTHUR",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-07-29",
"last_updated": "2020-07-10",
"certification_date": "2020-07-10",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "WA",
"license": "DE60022541",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Portland, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.