NPIMap

Organization Active NPI

Concept 3000 Dental Inc

  • Dentist
  • Toledo, OH
National Provider Identifier
1316019540
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
14687 Issued in OH
Legal business name
CONCEPT 3000 DENTAL INC
Doing business as
C Randall Koepke DDS
Practice address
6000 Renaissance Place
Suite B
Toledo, OH 43623-4715
Phone
(419) 882-1300
NPI assigned
Nov 14, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Charles Randall Koepke, DDSNPI 1629388012
Title
Owner Dentist
Phone
(419) 882-1300

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 14687 OH Primary

Addresses

Primary practice location

6000 Renaissance Place
Suite B
Toledo, OH 43623-4715

Mailing address

6000 Renaissance Place
Suite B
Toledo, OH 43623-4715
Phone (419) 882-1300

Other names 1

  • C Randall Koepke DDS Doing business as

National Provider Directory

National Provider Directory

Locations

6000 Renaissance Pl
Ste B
Toledo, OH 43623
Phone (419) 882-1300

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1316019540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6000 RENAISSANCE PLACE",
            "address_2": "SUITE B",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436234715",
            "telephone_number": "419-882-1300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6000 RENAISSANCE PLACE",
            "address_2": "SUITE B",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436234715",
            "telephone_number": "419-882-1300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONCEPT 3000 DENTAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KOEPKE",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "RANDALL",
        "authorized_official_title_or_position": "OWNER DENTIST",
        "authorized_official_telephone_number": "419-882-1300",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "OH",
            "license": "14687",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "C Randall Koepke DDS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Toledo, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.