MEDICARE: GRANT DAVID HOOPER DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	30.026345	OH
2	122300000X	Dentist	D012299	AZ

General Provider Information

NPI Number	:	1528692431
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GRANT DAVID HOOPER DDS

Provider Business Mailing Address
First Line	:	1640 E RIVER RD STE 112
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85718-7645
Country	:	US
Telephone Number	:	520-299-4470
Fax Number	:

Provider Business Practice Location Address
First Line	:	1640 E RIVER RD STE 112
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85718-7645
Country	:	US
Telephone Number	:	520-299-4470
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/29/2020
Last Update Date	:	06/16/2025

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Directions to “ GRANT DAVID HOOPER DDS” Practice Location

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