Hodge, Jeremy L

Hodge, Jeremy L is an individual health care provider with primary practice located at 9012 Mathis Ave , Manassas VA 20110-5218. He recently has 2 registered licenses in different health care specialties including Dental Providers / Dentist, Dental Providers / General Practice. Dental Providers / Dentist is his primary health care specialty. Hodge, Jeremy L can be contacted via phone (571) 912-1111.

Contact Information

Primary practice address
9012 Mathis Ave Manassas VA 20110-5218
Phone: (571) 912-1111
Fax: (571) 921-1112
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X 0101413727 Virginia
Dental Providers / General Practice 1223G0001X D3808 Idaho

Profile Details

NPI number 1194891242
LBN Legal business name Hodge, Jeremy L
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 28th, 2006
Last updated Feb 20th, 2024 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1194891242 NPPES
Virginia Other 806913500 DENTAQUEST
Virginia Other 6K216 DENTAQUEST

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