Provider Demographics
NPI:1578711362
Name:JEFFREY D HOPKINS DDS MD PA
Entity Type:Organization
Organization Name:JEFFREY D HOPKINS DDS MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:DONALD
Authorized Official - Last Name:HOPKINS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-298-6641
Mailing Address - Street 1:3450 W WHEATLAND RD
Mailing Address - Street 2:SUITE 425
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75237-3470
Mailing Address - Country:US
Mailing Address - Phone:972-298-6641
Mailing Address - Fax:972-298-2749
Practice Address - Street 1:3450 W WHEATLAND RD
Practice Address - Street 2:425
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75237-3470
Practice Address - Country:US
Practice Address - Phone:972-298-6641
Practice Address - Fax:972-298-2749
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-04
Last Update Date:2008-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ72792086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXG95516Medicare UPIN
TX00855UMedicare PIN