Provider Demographics
NPI:1326328600
Name:HOPKE, CORWYN D (DDS)
Entity Type:Individual
Prefix:DR
First Name:CORWYN
Middle Name:D
Last Name:HOPKE
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 1:4928 DUDLEY ST APT 5
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68504-3191
Mailing Address - Country:US
Mailing Address - Phone:503-704-3533
Mailing Address - Fax:
Practice Address - Street 1:40TH AND HOLDREGE STREETS
Practice Address - Street 2:UNMC COLLEGE OF DENTISTRY
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68583-0740
Practice Address - Country:US
Practice Address - Phone:402-472-4919
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-18
Last Update Date:2011-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE6983122300000X, 1223X0400X, 390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
No122300000XDental ProvidersDentist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program