Individual provider Active NPI

G. Robert Hopper, D.D.S.

  • General Practice Dentistry
  • Jackson, TN
National Provider Identifier
1245313485
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2894 Issued in TN
Practice address
468 N Parkway
Jackson, TN 38305-2857
Phone
(731) 664-5615
Fax
(731) 660-9805
NPI assigned
Oct 23, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 2894 TN Primary

Addresses

Primary practice location

468 N Parkway
Jackson, TN 38305-2857

Mailing address

468 N Parkway
Jackson, TN 38305-2857
Phone (731) 664-5615

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160303000023 TN Order and Referring Only - DentistPractitioner - Dentist 3375792393

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
G. Robert Hopper, D.D.S., P.C. PastSince Jun 29, 2012 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1245313485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "468 N PARKWAY",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383052857",
            "telephone_number": "731-664-5615",
            "fax_number": "731-660-9805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "468 N PARKWAY",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383052857",
            "telephone_number": "731-664-5615",
            "fax_number": "731-660-9805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOPPER",
        "first_name": "G.",
        "middle_name": "ROBERT",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TN",
            "license": "2894",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, TN

Sources for this page

Verify at the official NPI Registry.