NPIMap

Organization Active NPI

Hodge Dental, PLLC

  • Dental Clinic/Center
  • Blytheville, AR
National Provider Identifier
1881114478
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
1226 Issued in AR
Legal business name
HODGE DENTAL, PLLC
Practice address
501 N 6TH St
Blytheville, AR 72315-2407
Phone
(780) 763-2100
Fax
(870) 762-5383
NPI assigned
Jun 23, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Dr. Gray Hodge, DMDNPI 1255851846
Title
Dentist
Phone
(870) 763-2100

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X 1226 AR Primary

Addresses

Primary practice location

501 N 6TH St
Blytheville, AR 72315-2407

Mailing address

501 N 6TH St
Blytheville, AR 72315-2407
Phone (780) 763-2100

Other names 1

  • Hodge Dental Doing business as

National Provider Directory

National Provider Directory

Locations

501 N 6th St
Blytheville, AR 72315
Phone (870) 763-2100

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1498176000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1881114478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 N 6TH ST",
            "city": "BLYTHEVILLE",
            "state": "AR",
            "postal_code": "723152407",
            "telephone_number": "780-763-2100",
            "fax_number": "870-762-5383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 N 6TH ST",
            "city": "BLYTHEVILLE",
            "state": "AR",
            "postal_code": "723152407",
            "telephone_number": "780-763-2100",
            "fax_number": "870-762-5383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HODGE DENTAL, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-23",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "HODGE",
        "authorized_official_first_name": "GRAY",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "870-763-2100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "AR",
            "license": "1226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hodge Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Blytheville, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.