Healthcare Provider Details

I. General information

NPI: 1073536843
Provider Name (Legal Business Name): DENNIS GORDON HOPKINS D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/25/2006
Last Update Date: 04/09/2024
Certification Date: 04/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44100 JEFFERSON ST STE D404
INDIO CA
92201-2714
US

IV. Provider business mailing address

2748 MILTON WAY SUITE 202
MILTON WA
98354-9382
US

V. Phone/Fax

Practice location:
  • Phone: 760-772-0583
  • Fax:
Mailing address:
  • Phone: 253-927-5501
  • Fax: 253-952-4461

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDDS102137
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number5440
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: