Blake Kopf, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

D1188 Issued in SD

Practice address

11 Court St
Vermillion, SD 57069

Phone

(605) 624-8695

NPI assigned

May 29, 2018

Sex

Male

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

Practice roles

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.

• Kopf Dental Group

  • General Practice Dentistry
  • Vermillion, SD
  • NPI 1952763849
  NPD (past)
• Vermillion Dental Health

  • Dentist
  • Vermillion, SD
  • NPI 1417070624
  NPD (past)

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

{
    "created_epoch": "1527552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528848000000",
    "number": "1144711896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "54486 852 RD",
            "city": "PIERCE",
            "state": "NE",
            "postal_code": "687673602",
            "telephone_number": "402-885-0555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 COURT ST",
            "city": "VERMILLION",
            "state": "SD",
            "postal_code": "57069",
            "telephone_number": "605-624-8695"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1302 Verges Ave",
            "address_purpose": "LOCATION",
            "city": "Norfolk",
            "state": "NE",
            "postal_code": "687013606",
            "country_code": "US",
            "telephone_number": "402-371-0886",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOPF",
        "first_name": "BLAKE",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-29",
        "last_updated": "2018-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NE",
            "license": "7452",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "SD",
            "license": "D1188",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shelby Keeton, DDS
• Knutson Familty Dentistry LLP
• Matthew Richard Knutson, DDS
• Richard Leonard Knutson, DDS
• Kopf Dental Group
• Solveig Sperati Korte
• Matthew D Krell, MD
• Kia Kronaizl
• Ian David Lackey, ATC
• Adam Lawrence Ladwig, DPT

• Dentist in Vermillion, SD
• Providers in Vermillion, SD by specialty
• Dentist in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2018; 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.