Provider Demographics
NPI:1427313253
Name:HOPPE, MICHAEL WAYNE (DDS)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:WAYNE
Last Name:HOPPE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:720 OSTERMAN AVE
Mailing Address - Street 2:#305
Mailing Address - City:DEERFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60015-4471
Mailing Address - Country:US
Mailing Address - Phone:847-945-1600
Mailing Address - Fax:
Practice Address - Street 1:720 OSTERMAN AVE
Practice Address - Street 2:#305
Practice Address - City:DEERFIELD
Practice Address - State:IL
Practice Address - Zip Code:60015-4471
Practice Address - Country:US
Practice Address - Phone:847-945-1600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-09
Last Update Date:2012-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019028981122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist