Susanne M Kupka-Moore, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

046184-1 Issued in NY

Practice address

34 Duncan St
Warsaw, NY 14569-1017

Phone

(585) 786-3676

Fax

(585) 786-3896

NPI assigned

Mar 19, 2007

Sex

Female

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 2

Other names 1

• Dr. Susanne M Kupka Former name

Medicare fee-for-service enrollment

Enrolled in NY

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

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.

• Gburek Barone & Kupka DDS PC

  • General Practice Dentistry
  • Warsaw, NY
  • NPI 1780708339
  NPD (past)

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

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1477677003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34 DUNCAN ST",
            "city": "WARSAW",
            "state": "NY",
            "postal_code": "145691017",
            "telephone_number": "585-786-3676",
            "fax_number": "585-786-3896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34 DUNCAN ST",
            "city": "WARSAW",
            "state": "NY",
            "postal_code": "145691017",
            "telephone_number": "585-786-3676",
            "fax_number": "585-786-3896"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUPKA-MOORE",
        "first_name": "SUSANNE",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-19",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "046184-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02172916",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL TAX ID",
            "identifier": "161350913",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUSANNE",
            "last_name": "KUPKA",
            "middle_name": "M",
            "prefix": "DR.",
            "credential": "D.M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Lisa Marie Kemp, FNP
• Mitchell Kibler
• Richard Kingston
• Jacqueline Marie Klump
• Julie Krajewski, LPN
• Danielle Lynn Kwiecien
• Robin Kwiecien
• Ik-Sung Kwon, M.D.
• Deborah Labounty
• Elizabeth Anne Laczi, RSLP

• General Practice Dentistry in Warsaw, NY
• Providers in Warsaw, NY by specialty
• General Practice Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.