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NPI Code Detail

MEDICARE: BRIANNA NICOLE HODAK DDS

MEDICARE: BRIANNA NICOLE HODAK DDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry4851WV

General Provider Information

NPI Number : 1750214862
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRIANNA NICOLE HODAK DDS
Provider Business Mailing Address
First Line : 1520 WASHINGTON ST E
Second Line :
City : CHARLESTON
State : WV
Zip : 25311-2511
Country : US
Telephone Number : 304-414-5929
Fax Number :
Provider Business Practice Location Address
First Line : 1520 WASHINGTON ST E
Second Line :
City : CHARLESTON
State : WV
Zip : 25311-2511
Country : US
Telephone Number : 304-414-5929
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/08/2026
Last Update Date : 06/08/2026

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Directions to “ BRIANNA NICOLE HODAK DDS” Practice Location

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