Active NPI
John W Hudson, DDS
- Oral & Maxillofacial Surgery (D.M.D.)
- Knoxville, TN
National Provider Identifier
1922020379
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Oral & Maxillofacial Surgery (D.M.D.)
- License
- DS006030
- Practice address
- 1930 Alcoa Hwy
Ste 335
Knoxville, TN 37920-1500 - Phone
- (865) 544-9021
- Fax
- (865) 544-9565
- NPI assigned
- Jul 24, 2006
- 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 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Oral and Maxillofacial Surgery (Dentist) | 1223S0112X | DS006030 | TN | |
| Oral & Maxillofacial Surgery (D.M.D.) | 204E00000X | DS006030 | TN | Primary |
| Oral & Maxillofacial Surgery (D.M.D.) | 204E00000X | 2901014026 | MI | |
| Undersea and Hyperbaric Medicine (Emergency Medicine) Physician | 207PE0005X | CERTIFICATE | CA | |
| Undersea and Hyperbaric Medicine (Preventive Medicine) Physician | 2083P0011X | CERTIFICATE | CA |
Addresses
Primary practice location
1930 Alcoa Hwy
Ste 335
Knoxville, TN 37920-1500
Mailing address
1930 Alcoa Hwy
Ste 335
Knoxville, TN 37920-1500
Phone (865) 544-9021
Other identifiers 17
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3224723 | Medicaid | TN | |
| 199845 | Other | TN | CIGNA DENTAL DMO OFFC 2 |
| 199846 | Other | TN | CIGNA DENTAL DMO OFFC 3 |
| DS006030 | Other | TN | LICENSE |
| 732021 | Other | UT | DENTAL BEN. PROV. OFFC 1 |
| 64777451 | Other | KY | KENTUCKY MEDICAID |
| 732022 | Other | UT | DENTAL BEN. PROV. OFFC 2 |
| TN0103 | Other | TN | AMERICHOICE TENNCARE O-2 |
| 1211270 | Other | TN | CIGNA DENTAL DMO OFFC 1 |
| 199845 | Other | TN | CIGNA DENTAL PPO OFFC 2 |
| 621199959 | Other | TN | CIGNA DENTAL PPO |
| 732023 | Other | UT | DENTAL BEN. PROV. OFFC 3 |
| 0015837 | Other | BLUE CROSS BLUE SHIELD | |
| 199846 | Other | TN | CIGNA DENTAL PPO OFFC3 |
| TN0102 | Other | TN | AMERICHOICE TENNCARE O-1 |
| 0005113 | Other | IA | ASSURANT EMPLOYEE BENEFIT |
| TN0104 | Other | TN | AMERICHOICE TENNCARE O-3 |
Other names 1
- Dr. J W Hudson
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
| License | State | Type | Specialty |
|---|---|---|---|
| DS006030 | TN | MD | Oral and Maxillofacial Surgery (Dentist) |
| CERTIFICATE | CA | MD | Peer Specialist |
| 2901014026 | MI | MD | Oral & Maxillofacial Surgery (D.M.D.) |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153699200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1208390400000",
"number": "1922020379",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1930 ALCOA HWY",
"address_2": "STE 335",
"city": "KNOXVILLE",
"state": "TN",
"postal_code": "379201500",
"telephone_number": "865-544-9021",
"fax_number": "865-544-9565"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1930 ALCOA HWY",
"address_2": "STE 335",
"city": "KNOXVILLE",
"state": "TN",
"postal_code": "379201500",
"telephone_number": "865-544-9021",
"fax_number": "865-544-9565"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HUDSON",
"first_name": "JOHN",
"middle_name": "W",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-24",
"last_updated": "2008-04-17",
"status": "A"
},
"taxonomies": [
{
"code": "1223S0112X",
"taxonomy_group": "",
"desc": "Dentist, Oral and Maxillofacial Surgery",
"state": "TN",
"license": "DS006030",
"primary": false
},
{
"code": "204E00000X",
"taxonomy_group": "",
"desc": "Oral & Maxillofacial Surgery",
"state": "TN",
"license": "DS006030",
"primary": true
},
{
"code": "204E00000X",
"taxonomy_group": "",
"desc": "Oral & Maxillofacial Surgery",
"state": "MI",
"license": "2901014026",
"primary": false
},
{
"code": "207PE0005X",
"taxonomy_group": "",
"desc": "Emergency Medicine, Undersea and Hyperbaric Medicine",
"state": "CA",
"license": "CERTIFICATE",
"primary": false
},
{
"code": "2083P0011X",
"taxonomy_group": "",
"desc": "Preventive Medicine, Undersea and Hyperbaric Medicine",
"state": "CA",
"license": "CERTIFICATE",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3224723",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA DENTAL DMO OFFC 2",
"identifier": "199845",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA DENTAL DMO OFFC 3",
"identifier": "199846",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "DS006030",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DENTAL BEN. PROV. OFFC 1",
"identifier": "732021",
"state": "UT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "KENTUCKY MEDICAID",
"identifier": "64777451",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DENTAL BEN. PROV. OFFC 2",
"identifier": "732022",
"state": "UT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERICHOICE TENNCARE O-2",
"identifier": "TN0103",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA DENTAL DMO OFFC 1",
"identifier": "1211270",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA DENTAL PPO OFFC 2",
"identifier": "199845",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA DENTAL PPO",
"identifier": "621199959",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DENTAL BEN. PROV. OFFC 3",
"identifier": "732023",
"state": "UT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "0015837",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA DENTAL PPO OFFC3",
"identifier": "199846",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERICHOICE TENNCARE O-1",
"identifier": "TN0102",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ASSURANT EMPLOYEE BENEFIT",
"identifier": "0005113",
"state": "IA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERICHOICE TENNCARE O-3",
"identifier": "TN0104",
"state": "TN"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "J",
"last_name": "HUDSON",
"middle_name": "W",
"prefix": "DR.",
"credential": "DDS",
"code": "2",
"type": "Professional Name"
}
]
}Other providers in Knoxville, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 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.