Individual provider Active NPI

Joel Kenneth Hopkin, DMD MD

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Salem, OR
National Provider Identifier
1417940289
Registry record updated Jun 23, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X
License
D7858 Issued in OR
Practice address
2266 Mission St SE
Salem, OR 97302-1267
Phone
(503) 375-2000
Fax
(503) 375-3125
NPI assigned
Aug 26, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral & Maxillofacial Surgery (D.M.D.) 204E00000X D7858 OR Primary

Addresses

Primary practice location

2266 Mission St SE
Salem, OR 97302-1267

Mailing address

2266 Mission St SE
Salem, OR 97302-1267
Phone (503) 375-2000

Other identifiers 1

IdentifierTypeStateIssuer
230636MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20210112001362 OR Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 6002809696

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
D7858ORMDOral & Maxillofacial Surgery (D.M.D.)

NPI Registry JSON

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

{
    "created_epoch": "1125014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277251200000",
    "number": "1417940289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2266 MISSION ST SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973021267",
            "telephone_number": "503-375-2000",
            "fax_number": "503-375-3125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2266 MISSION ST SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973021267",
            "telephone_number": "503-375-2000",
            "fax_number": "503-375-3125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOPKIN",
        "first_name": "JOEL",
        "middle_name": "KENNETH",
        "name_prefix": "Dr.",
        "credential": "DMD MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-26",
        "last_updated": "2010-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "OR",
            "license": "D7858",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "230636",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, OR

Sources for this page

Verify at the official NPI Registry.