Healthcare Provider Details
I. General information
NPI: 1336024124
Provider Name (Legal Business Name): MATTHEW HUDZINSKI DMD LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/11/2025
Last Update Date: 08/11/2025
Certification Date: 07/30/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1232 SOM CENTER RD
MAYFIELD HEIGHTS OH
44124-2047
US
IV. Provider business mailing address
32991 CHARMWOOD OVAL
SOLON OH
44139-4422
US
V. Phone/Fax
- Phone: 440-409-5857
- Fax:
- Phone: 440-409-5857
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 122300000X |
| Taxonomy | Dentist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 1223G0001X |
| Taxonomy | General Practice Dentistry |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
MATTHEW
EDWARD
HUDZINSKI
Title or Position: DENTIST
Credential: DMD
Phone: 440-409-5857