Provider Demographics
NPI:1235215096
Name:BRAD HOOPES DDS, PC
Entity Type:Organization
Organization Name:BRAD HOOPES DDS, PC
Other - Org Name:BRAD HOOPES DDS, PLLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BRAD
Authorized Official - Middle Name:
Authorized Official - Last Name:HOOPES
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:918-682-1055
Mailing Address - Street 1:3300 CHANDLER RD
Mailing Address - Street 2:SUITE 111
Mailing Address - City:MUSKOGEE
Mailing Address - State:OK
Mailing Address - Zip Code:74403-4909
Mailing Address - Country:US
Mailing Address - Phone:918-682-1055
Mailing Address - Fax:918-682-6436
Practice Address - Street 1:3300 CHANDLER RD
Practice Address - Street 2:SUITE 111
Practice Address - City:MUSKOGEE
Practice Address - State:OK
Practice Address - Zip Code:74403-4909
Practice Address - Country:US
Practice Address - Phone:918-682-1055
Practice Address - Fax:918-682-6436
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK43651223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty