Individual provider Active NPI

Bradley Jay Hoppens, DDS

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Ogallala, NE
National Provider Identifier
1053687947
Registry record updated Mar 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
5159 Issued in NE
Practice address
112 W 4TH St
Ogallala, NE 69153-2564
Phone
(308) 284-4421
Fax
(308) 284-6616
NPI assigned
Mar 26, 2012
Last updated
Mar 26, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 26, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 5159 NE Primary

Addresses

Primary practice location

112 W 4TH St
Ogallala, NE 69153-2564

Mailing address

112 W 4TH St
Ogallala, NE 69153-2564
Phone (308) 284-4421

Other identifiers 1

IdentifierTypeStateIssuer
470683740MedicaidNE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
5159NEMDOrthodontics and Dentofacial Orthopedic Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Bradley J Hoppens PC Orthodontics and Dentofacial Orthopedics Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1332720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332720000000",
    "number": "1053687947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 W 4TH ST",
            "city": "OGALLALA",
            "state": "NE",
            "postal_code": "691532564",
            "telephone_number": "308-284-4421",
            "fax_number": "308-284-6616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 W 4TH ST",
            "city": "OGALLALA",
            "state": "NE",
            "postal_code": "691532564",
            "telephone_number": "308-284-4421",
            "fax_number": "308-284-6616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOPPENS",
        "first_name": "BRADLEY",
        "middle_name": "JAY",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-03-26",
        "last_updated": "2012-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "NE",
            "license": "5159",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "470683740",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ogallala, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.