MEDICARE: PAUL D HOPKINS DDS PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	144563	UT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	45094675601001	OTHER	UT	BCBS OF UTAH
3	591998	OTHER		UNITED CONCORDIA

General Provider Information

NPI Number	:	1477662187
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PAUL D HOPKINS DDS PC

Provider Business Mailing Address
First Line	:	859 W PLEASANT VIEW DR
Second Line	:
City	:	PLEASANT VIEW
State	:	UT
Zip	:	84414
Country	:	US
Telephone Number	:	801-737-4477
Fax Number	:	801-737-0626

Provider Business Practice Location Address
First Line	:	859 W PLEASANT VIEW DR
Second Line	:
City	:	PLEASANT VIEW
State	:	UT
Zip	:	84414
Country	:	US
Telephone Number	:	801-737-4477
Fax Number	:	801-737-0626

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. PAUL DUANE HOPKINS
Credential	:	DDS PC
Telephone Number	:	801-773-1234

Provider Enumeration Date	:	08/29/2006
Last Update Date	:	08/22/2020

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