Larry G Hubbard, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

9053 Issued in GA

Practice address

1007 E Barnard St
Glennville, GA 30427-2603

Phone

(912) 654-3046

Fax

(912) 654-3047

NPI assigned

Aug 17, 2006

Last updated

Dec 19, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

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

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702944000000",
    "number": "1801909445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 718",
            "city": "GLENNVILLE",
            "state": "GA",
            "postal_code": "304270718",
            "telephone_number": "912-654-3046",
            "fax_number": "912-654-3047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1007 E BARNARD ST",
            "city": "GLENNVILLE",
            "state": "GA",
            "postal_code": "304272603",
            "telephone_number": "912-654-3046",
            "fax_number": "912-654-3047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUBBARD",
        "first_name": "LARRY",
        "middle_name": "G",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-17",
        "last_updated": "2023-12-19",
        "certification_date": "2023-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "GA",
            "license": "9053",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "9053",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Glenvue H&R Nursing LLC (Glenvue Health and Rehabilitation)
• Glenvue Operations LLC (Glenvue Health & Rehab)
• Michelle Ledesma Glisson
• Victoria Kangeter Griffith, D.P.T.
• Joseph C Hand III, M.D.
• Jessica Joyner Huggins
• Kenneth Brant Kicklighter Jr., PHARMD.
• Hee-Jun Gregory Kim, MD
• Brennan Elizabeth King
• Lee Joshua Martin, D.M.D.

• General Practice Dentistry in Glennville, GA
• Providers in Glennville, GA by specialty
• General Practice Dentistry in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2023; 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.