Provider Demographics
NPI:1588787964
Name:HOPKINS, JEREMY C (DDS)
Entity type:Individual
Prefix:DR
First Name:JEREMY
Middle Name:C
Last Name:HOPKINS
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:PO BOX 189
Mailing Address - Street 2:
Mailing Address - City:LANGLEY
Mailing Address - State:OK
Mailing Address - Zip Code:74350
Mailing Address - Country:US
Mailing Address - Phone:918-782-2009
Mailing Address - Fax:918-782-1042
Practice Address - Street 1:1666 N 3RD ST.
Practice Address - Street 2:
Practice Address - City:LANGLEY
Practice Address - State:OK
Practice Address - Zip Code:74350
Practice Address - Country:US
Practice Address - Phone:918-782-2009
Practice Address - Fax:918-782-1042
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-09
Last Update Date:2022-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK53241223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice