Healthcare Provider Details

I. General information

NPI: 1770687790
Provider Name (Legal Business Name): JONATHAN RICHMOND HOPKINS D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/11/2006
Last Update Date: 11/12/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3206 LANGLEY DR
SEARCY AR
72143-6020
US

IV. Provider business mailing address

406 JENNIFER LN
SEARCY AR
72143-5060
US

V. Phone/Fax

Practice location:
  • Phone: 501-268-2000
  • Fax: 501-279-2001
Mailing address:
  • Phone: 501-305-9119
  • Fax: 501-279-2001

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number3262
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: