Carmen Lee Koepl

Primary specialty

Dental HygienistTaxonomy code 124Q00000X

License

DH-3679 Issued in ID

Practice address

803 S Main St Ste 120
Moscow, ID 83843-2695

Phone

(208) 848-8300

Fax

(208) 882-5587

NPI assigned

Aug 31, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1535673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617148800000",
    "number": "1073095501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 N IRON BRIDGE WAY",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992024932",
            "telephone_number": "509-444-8888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "803 S MAIN ST STE 120",
            "city": "MOSCOW",
            "state": "ID",
            "postal_code": "838432695",
            "telephone_number": "208-848-8300",
            "fax_number": "208-882-5587"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOEPL",
        "first_name": "CARMEN",
        "middle_name": "LEE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-31",
        "last_updated": "2021-03-31",
        "certification_date": "2021-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "WA",
            "license": "DH60888742",
            "primary": false
        },
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "ID",
            "license": "DH-3679",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shane Kinzer, OD
• Martha A Kitzrow, PHD
• Jeff Kline
• Randall F Kloepfer, M.D.
• Karen Alice Knoff, M.A.
• Maria C Konen, CRNA
• Nicole Konen
• Doree Erika Kovis-Tonks, LCSW
• Taylor Lynn Krasselt
• Ruth Margaret Krause, CD (DONA)

• Dental Hygienist in Moscow, ID
• Providers in Moscow, ID by specialty
• Dental Hygienist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.