Individual provider Active NPI

Andrew John Hoppe, D.D.S

  • Dentist
  • St Augustine, FL
National Provider Identifier
1134449234
Registry record updated Apr 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2901020286 Issued in MI
Practice address
3043 International Golf Pkwy
St Augustine, FL 32092-0032
Phone
(904) 940-3933
NPI assigned
Jun 11, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN24759 FL
Dentist 122300000X 2901020286 MI Primary

Addresses

Primary practice location

3043 International Golf Pkwy
St Augustine, FL 32092-0032

Mailing address

70 Rialto Dr
Ponte Vedra, FL 32081-6118
Phone (586) 549-3206

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
DN24759FLMDDentist
2901020286MIMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1276214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712620800000",
    "number": "1134449234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70 RIALTO DR",
            "city": "PONTE VEDRA",
            "state": "FL",
            "postal_code": "320816118",
            "telephone_number": "586-549-3206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3043 INTERNATIONAL GOLF PKWY",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320920032",
            "telephone_number": "904-940-3933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOPPE",
        "first_name": "ANDREW",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-11",
        "last_updated": "2024-04-09",
        "certification_date": "2024-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN24759",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901020286",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Augustine, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2024; 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.