Individual provider Active NPI

Ashley Ann-Robbins Koppel, DDS

  • General Practice Dentistry
  • Vista, CA
National Provider Identifier
1033730593
Registry record updated Sep 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DDS106622 Issued in CA
Practice address
620 S Melrose Dr Ste 201
Vista, CA 92081-6644
Phone
(760) 945-4189
NPI assigned
May 6, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DDS106622 CA Primary

Addresses

Primary practice location

620 S Melrose Dr Ste 201
Vista, CA 92081-6644

Mailing address

490 Moraga Way
Oceanside, CA 92058-7998

Other practice location 1

3144 El Camino Real Ste 101
Carlsbad, CA 92008-2194
Phone (760) 434-9800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210922001654 CA Order and Referring Only - DentistPractitioner - Dentist 8729485479

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DDS106622CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Ashley & Benjamin Koppel DDS Inc General Practice CurrentSince Jul 16, 2023 Accepting new patients

Locations

620 S Melrose Dr
Ste 201
Vista, CA 92081
Phone (760) 554-8825

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1588723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695859200000",
    "number": "1033730593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "490 MORAGA WAY",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920587998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 S MELROSE DR STE 201",
            "city": "VISTA",
            "state": "CA",
            "postal_code": "920816644",
            "telephone_number": "760-945-4189"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3144 El Camino Real Ste 101",
            "address_purpose": "LOCATION",
            "city": "Carlsbad",
            "state": "CA",
            "postal_code": "920082194",
            "country_code": "US",
            "telephone_number": "760-434-9800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOPPEL",
        "first_name": "ASHLEY",
        "middle_name": "ANN-ROBBINS",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-06",
        "last_updated": "2023-09-28",
        "certification_date": "2023-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "DDS106622",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vista, CA

Sources for this page

Verify at the official NPI Registry.