Individual provider Active NPI

Russell E. Hudoba, DDS

  • Periodontics
  • Canfield, OH
National Provider Identifier
1891790713
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
16625 Issued in OH
Practice address
6674 Tippecanoe Rd
Ste 5
Canfield, OH 44406-9149
Phone
(330) 533-0600
Fax
(330) 702-1215
NPI assigned
Jun 16, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X 16625 OH Primary

Addresses

Primary practice location

6674 Tippecanoe Rd
Ste 5
Canfield, OH 44406-9149

Mailing address

6674 Tippecanoe Rd
Ste 5
Canfield, OH 44406-9149
Phone (330) 533-0600

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
16625OHMDPeriodontist

NPI Registry JSON

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

{
    "created_epoch": "1118880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1891790713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6674 TIPPECANOE RD",
            "address_2": "STE 5",
            "city": "CANFIELD",
            "state": "OH",
            "postal_code": "444069149",
            "telephone_number": "330-533-0600",
            "fax_number": "330-702-1215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6674 TIPPECANOE RD",
            "address_2": "STE 5",
            "city": "CANFIELD",
            "state": "OH",
            "postal_code": "444069149",
            "telephone_number": "330-533-0600",
            "fax_number": "330-702-1215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUDOBA",
        "first_name": "RUSSELL",
        "middle_name": "E.",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-16",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "OH",
            "license": "16625",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canfield, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.