Healthcare Provider Details

I. General information

NPI: 1700715083
Provider Name (Legal Business Name): ST. JOSEPH FAMILY DENTAL, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/14/2026
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3904 BECK RD STE 110
SAINT JOSEPH MO
64506-5037
US

IV. Provider business mailing address

3904 BECK RD STE 110
SAINT JOSEPH MO
64506-5037
US

V. Phone/Fax

Practice location:
  • Phone: 816-233-2672
  • Fax: 816-233-2672
Mailing address:
  • Phone: 816-233-2672
  • Fax: 816-233-2672

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: VAN HOPKINS
Title or Position: DENTIST
Credential: DDS
Phone: 816-233-2672