Active NPI
Stephen R Hooper, D.D.S.
- General Practice Dentistry
- Bossier City, LA
National Provider Identifier
1275697203
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 4193
- Practice address
- 2710 Douglas Dr
Suite C
Bossier City, LA 71111-3497 - Phone
- (318) 742-2272
- Fax
- (318) 742-2975
- NPI assigned
- Dec 21, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 4193 | LA | Primary |
Addresses
Primary practice location
2710 Douglas Dr
Suite C
Bossier City, LA 71111-3497
Mailing address
2710 Douglas Dr
Suite C
Bossier City, LA 71111-3497
Phone (318) 742-2272
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 804528 | Other | LA | UNITED CONCORDIA |
| G8212 | Other | LA | BLUE CROSS BLUE SHIELD LA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in LA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160707001570 | LA | Order and Referring Only - Dentist | 3870885122 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4193 | LA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166659200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1275697203",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2710 DOUGLAS DR",
"address_2": "SUITE C",
"city": "BOSSIER CITY",
"state": "LA",
"postal_code": "711113497",
"telephone_number": "318-742-2272",
"fax_number": "318-742-2975"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2710 DOUGLAS DR",
"address_2": "SUITE C",
"city": "BOSSIER CITY",
"state": "LA",
"postal_code": "711113497",
"telephone_number": "318-742-2272",
"fax_number": "318-742-2975"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOOPER",
"first_name": "STEPHEN",
"middle_name": "R",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-12-21",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "LA",
"license": "4193",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED CONCORDIA",
"identifier": "804528",
"state": "LA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD LA",
"identifier": "G8212",
"state": "LA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bossier City, LA
- John Hayden Holtzclaw, AU.D.
- Jomesia Precious la'Joya Honeycutt
- Anthony Michael Hooker Jr.
- Hooper Family Dentistry, Inc
- Christopher Grey Hooper, D.D.S.
- Mallory Oliver Hoopingarner, NP
- Hope Behaviorial Intervention Services Inc.
- Hope Springs Counseling Center, LLC
- John J Horan, MD
- Horizon Recovery Iop Bossier LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.