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General NPI Number Information
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NPI Number | 1396538542
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Entity Type | Individual
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Provider Name | DARRIAN HODGES
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Gender | Male
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Dates
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Enumeration Date | 05/28/2025
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Last Update Date | 05/28/2025
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Provider Practice Location Address
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Address Line | 2301 E ALLEGHENY AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19134-4427
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Country | US
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Telephone | 267-367-5011
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Fax |
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Provider Business Mailing Address
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Address Line | 4201 COLONIAL DR
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City | COLUMBIA
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State | SC
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Zip | 29203-6648
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Country | US
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Telephone | 803-920-2495
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DGD.10952
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License Number State | SC
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