Organization Active NPI

Dustin J Hopkin DDS, Oral and Maxillofacial Surgery P.C.

  • Oral and Maxillofacial Surgery Clinic/Center
  • Salt Lake City, UT
National Provider Identifier
1376827832
Registry record updated Nov 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery Clinic/CenterTaxonomy code 261QS0112X
License
7752965 Issued in UT
Legal business name
DUSTIN J HOPKIN DDS, ORAL AND MAXILLOFACIAL SURGERY P.C.
Practice address
2180 E 4500 S Ste 285
Salt Lake City, UT 84117-4028
Phone
(801) 277-3942
Fax
(801) 277-4505
NPI assigned
Oct 3, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2016

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

Authorized official

Name
Dr. Dustin John Hopkin, DDSNPI 1265690028
Title
President
Phone
(801) 277-3942

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery Clinic/Center 261QS0112X 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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120110000142 UT Part B Supplier - Clinic/Group Practice 4688840804 Receives reassigned benefits from 1 practitioner
Practice locations: Salt Lake City, UT

National Provider Directory

National Provider Directory

Locations

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

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1317600000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1479081600000",
    "number": "1376827832",
    "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": {
        "organization_name": "DUSTIN J HOPKIN DDS, ORAL AND MAXILLOFACIAL SURGERY P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-03",
        "last_updated": "2016-11-14",
        "status": "A",
        "authorized_official_last_name": "HOPKIN",
        "authorized_official_first_name": "DUSTIN",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "801-277-3942",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QS0112X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, 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

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.