Charles Randall Koepke, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

14687 Issued in OH

Practice address

6000 Renaissance PL
Suite B
Toledo, OH 43623-4714

Phone

(419) 882-1300

NPI assigned

Oct 19, 2010

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

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.

• Concept 3000 Dental Inc

  • Dentist
  • Toledo, OH
  • NPI 1316019540
  NPD (past) Authorized official
• Sylvania Dental, Greg Theis, LLC

  • General Practice Dentistry
  • Toledo, OH
  • NPI 1659716231
  NPD (past)

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

{
    "created_epoch": "1287446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287446400000",
    "number": "1629388012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6000 RENAISSANCE PL",
            "address_2": "SUITE B",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436234714",
            "telephone_number": "419-882-1300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6000 RENAISSANCE PL",
            "address_2": "SUITE B",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436234714",
            "telephone_number": "419-882-1300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOEPKE",
        "first_name": "CHARLES",
        "middle_name": "RANDALL",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-10-19",
        "last_updated": "2010-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "14687",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lawrence Kodjiku
• Anamaria Chacin Koehl, M.D.
• Theresa Koehnle
• Adam Koenig, MD
• Nathan Koenig
• Richard A Koepke, D.O.
• Belinda M Koester, RN
• Brittney Koester
• Derek Koester, AT, ATC
• Melissa Anne Koester, RNFA

• General Practice Dentistry in Toledo, OH
• Providers in Toledo, OH by specialty
• General Practice Dentistry in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2010; 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.