Healthcare Provider Details

I. General information

NPI: 1609745074
Provider Name (Legal Business Name): JOAN M. HOPKINS RDH ECPIII
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/03/2025
Last Update Date: 11/03/2025
Certification Date: 11/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3801 DR MARTIN LUTHER KING JR BLVD
KANSAS CITY MO
64130-2807
US

IV. Provider business mailing address

708 OWL CREEK PKWY
ODESSA MO
64076-1628
US

V. Phone/Fax

Practice location:
  • Phone: 816-923-5800
  • Fax: 816-599-5980
Mailing address:
  • Phone: 816-321-3855
  • Fax: 816-599-5980

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License Number13068
License Number StateKS
# 2
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License Number2003015400
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: