Individual provider Active NPI

Dustin J Hopkin, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Salt Lake City, UT
National Provider Identifier
1265690028
Registry record updated Oct 31, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
7752965 Issued in UT
Practice address
2180 E 4500 S Ste 285
Salt Lake City, UT 84117-4028
Phone
(801) 277-3942
Fax
(801) 277-4505
NPI assigned
May 29, 2008
Last updated
Oct 31, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X D-4552-OS ID
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 7752965 UT Primary

Addresses

Primary practice location

2180 E 4500 S Ste 285
Salt Lake City, UT 84117-4028

Mailing address

2180 E 4500 S Ste 285
Salt Lake City, UT 84117-4028
Phone (801) 277-3942

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111109000712 UT Practitioner - Oral SurgeryPractitioner - Maxillofacial Surgery 0143493015 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Oral SurgeryAlso: Maxillofacial Surgery
Education
University of Iowa College of Dentistry, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1377 E 3900
Suite 104
Salt Lake City, UT 84124-1492
Phone (801) 277-3942

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D-4552-OSIDMDOral and Maxillofacial Surgery (Dentist)
7752965UTMDOral and Maxillofacial Surgery (Dentist)

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services, Inc. CurrentSince Jan 1, 2020 Accepting new patients
Dustin J Hopkin DDS, Oral and Maxillofacial Surgery P.C. CurrentSince Aug 1, 2011 Accepting new patients
Ihc Health Services Inc Current Accepting new patients
Ihc Health Services Inc CurrentSince Jan 1, 2020 Accepting new patients

Locations

1377 E 3900 S
Ste 104
Salt Lake Cty, UT 84124
Phone (801) 272-4249

400 C St
Salt Lake Cty, UT 84143
Phone (435) 688-4080

5121 S Cottonwood St
Salt Lake Cty, UT 84107
Phone (801) 408-8998

Networks

  • UT PPO D-SNP

Organizations & group practices 4

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": "1212019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477872000000",
    "number": "1265690028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2180 E 4500 S STE 285",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841174028",
            "telephone_number": "801-277-3942",
            "fax_number": "801-277-4505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2180 E 4500 S STE 285",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841174028",
            "telephone_number": "801-277-3942",
            "fax_number": "801-277-4505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOPKIN",
        "first_name": "DUSTIN",
        "middle_name": "J",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-29",
        "last_updated": "2016-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "ID",
            "license": "D-4552-OS",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "UT",
            "license": "7752965",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.