Provider Demographics
NPI:1336256544
Name:HARDEKOPF, JAMES DOUGLAS (DMD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:DOUGLAS
Last Name:HARDEKOPF
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8400 OSUNA NE
Mailing Address - Street 2:SUITE 1-A
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87111-2068
Mailing Address - Country:US
Mailing Address - Phone:505-275-0500
Mailing Address - Fax:505-275-0784
Practice Address - Street 1:8400 OSUNA NE
Practice Address - Street 2:SUITE 1-A
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87111-2068
Practice Address - Country:US
Practice Address - Phone:505-275-0500
Practice Address - Fax:505-275-0784
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM16031223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics