Shobha Mahesh Hosur, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

6128 Issued in AL

Practice address

553 N. Eastern Blvd
Montgomery, AL 36117

Phone

(334) 801-9800

Fax

(334) 801-9848

NPI assigned

Jul 31, 2014

Last updated

Apr 18, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AL

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

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Tooth Buds at Lagoon Park, LLC

  • General Practice Dentistry
  • Montgomery, AL
  • NPI 1114392107
  NPD (past)

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

{
    "created_epoch": "1406764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1460937600000",
    "number": "1861800088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "553 N. EASTERN BLVD",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "36117",
            "telephone_number": "334-801-9800",
            "fax_number": "334-801-9848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "553 N. EASTERN BLVD",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "36117",
            "telephone_number": "334-801-9800",
            "fax_number": "334-801-9848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOSUR",
        "first_name": "SHOBHA",
        "middle_name": "MAHESH",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-31",
        "last_updated": "2016-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AL",
            "license": "6128",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1003046772",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Holli Hosford, PMHNP-BC
• Douglas Mark Hoskins, PA
• Hospice Advantage, LLC.
• Hospice of Montgomery Inc
• Hospiscript Services LLC
• Hour Glass Optical
• Hour Glass Optical Lab. Inc.
• House of Serinity
• Jada Houser
• Keith Houston

• Dentist in Montgomery, AL
• Providers in Montgomery, AL by specialty
• Dentist in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2016; 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.