Healthcare Provider Details

I. General information

NPI: 1891990172
Provider Name (Legal Business Name): BRIAN P. HOFFMAN DMD, MPH, DICOI
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/18/2007
Last Update Date: 08/28/2024
Certification Date: 08/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1935 S RANGE LINE RD
JOPLIN MO
64804-3238
US

IV. Provider business mailing address

1182 S OAK RIDGE RD
NIXA MO
65714-8277
US

V. Phone/Fax

Practice location:
  • Phone: 417-726-4087
  • Fax:
Mailing address:
  • Phone: 813-446-6757
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDN17983
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number2021014991
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: