John Kupcha, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

17075 Issued in NJ

Practice address

308 Tuckerton Road
Medford, NJ 08055

Phone

(609) 654-2454

Fax

(609) 654-6568

NPI assigned

Jan 10, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in VA

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

Medicare enrollment (NPD)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Medford Family Dental Care PA

  • Dentist
  • Medford, NJ
  • NPI 1528076320
  NPD (past) Authorized official

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

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1285783043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "308 TUCKERTON ROAD",
            "city": "MEDFORD",
            "state": "NJ",
            "postal_code": "08055",
            "telephone_number": "609-654-2454",
            "fax_number": "609-654-6568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "308 TUCKERTON ROAD",
            "city": "MEDFORD",
            "state": "NJ",
            "postal_code": "08055",
            "telephone_number": "609-654-2454",
            "fax_number": "609-654-6568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUPCHA",
        "first_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NJ",
            "license": "17075",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2099306",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stephanie Kovatch, OTR/L
• Steven Dennis Kreh Jr., PHYSICAL THERAPIST
• Lindsey Kretschy, MPS, ATR-BC
• Michael L. Krusinski, D.M.D.
• Christopher J Kulas, DMD
• Dawn R Lahuta, RPH
• Cheryl L. Landry, PT
• Michael K Lanzilotta, D.C.
• John Raymond Law, D.C.
• Hailey Ann Layton, PT, DPT

• Dentist in Medford, NJ
• Providers in Medford, NJ by specialty
• Dentist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.