Active NPI
Joshua Ezekiel Hudson, D.D.S
- Dentist
- Conway, SC
National Provider Identifier
1891950440
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 4503
- Practice address
- 900 Main St # a
Conway, SC 29526-4063 - Phone
- (843) 488-3710
- NPI assigned
- Jul 23, 2008
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Dentist | 122300000X | 4503 | SC | Primary |
Addresses
Primary practice location
900 Main St # a
Conway, SC 29526-4063
Mailing address
3775 Sweetgum St
Myrtle Beach, SC 29577-5119
Phone (248) 250-4272
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1216771200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1216771200000",
"number": "1891950440",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3775 SWEETGUM ST",
"city": "MYRTLE BEACH",
"state": "SC",
"postal_code": "295775119",
"telephone_number": "248-250-4272"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "900 MAIN ST # A",
"city": "CONWAY",
"state": "SC",
"postal_code": "295264063",
"telephone_number": "843-488-3710"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HUDSON",
"first_name": "JOSHUA",
"middle_name": "EZEKIEL",
"credential": "D.D.S",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-07-23",
"last_updated": "2008-07-23",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "SC",
"license": "4503",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Conway, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.