Brittany Kopecky, DDS
Individual provider Active NPI Dentist · Watauga, TX
NPI 1609284579 · NPPES record last updated Sep 28, 2015
Key facts
- NPI
- 1609284579
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- TX30195 (TX)
- Practice address
- 5710 Watauga Rd
100
Watauga, TX 76148-3022 - Phone
- (817) 281-2061
- NPI assigned
- Jul 23, 2014
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| TX30195 | TX | MD | Dentist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | TX30195 | TX | Yes |
Addresses
Primary practice location
5710 Watauga Rd
100
Watauga, TX 76148-3022
Mailing address
6445 Durango Dr
Beaumont, TX 77708-3587
Other providers in Watauga, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 28, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.