Provider Demographics
NPI:1457452864
Name:PAUL D HOPKINS DDS PC
Entity Type:Organization
Organization Name:PAUL D HOPKINS DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:DUANE
Authorized Official - Last Name:HOPKINS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS PC
Authorized Official - Phone:801-773-1234
Mailing Address - Street 1:859 W PLEASANT VIEW DR
Mailing Address - Street 2:
Mailing Address - City:PLEASANT VIEW
Mailing Address - State:UT
Mailing Address - Zip Code:84414
Mailing Address - Country:US
Mailing Address - Phone:801-737-4477
Mailing Address - Fax:801-737-0626
Practice Address - Street 1:4902 S 1900 W SUITE 2
Practice Address - Street 2:
Practice Address - City:ROY
Practice Address - State:UT
Practice Address - Zip Code:84067
Practice Address - Country:US
Practice Address - Phone:801-773-1234
Practice Address - Fax:801-773-9611
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-26
Last Update Date:2010-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT144563122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
591998OtherUNITED CONCORDIA
UT45094675600001OtherBCBS OF UTAH
UT450946756017Medicaid