Provider Demographics
NPI:1265690028
Name:HOPKIN, DUSTIN J (DDS)
Entity Type:Individual
Prefix:
First Name:DUSTIN
Middle Name:J
Last Name:HOPKIN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2180 E 4500 S STE 285
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84117-4028
Mailing Address - Country:US
Mailing Address - Phone:801-277-3942
Mailing Address - Fax:801-277-4505
Practice Address - Street 1:2180 E 4500 S STE 285
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84117-4028
Practice Address - Country:US
Practice Address - Phone:801-277-3942
Practice Address - Fax:801-277-4505
Is Sole Proprietor?:No
Enumeration Date:2008-05-29
Last Update Date:2016-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDD-4552-OS1223S0112X
UT77529651223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery