Individual provider Active NPI

William Michael Kopp, D.M.D.

  • Endodontics
  • Hickory, NC
National Provider Identifier
1639192180
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
4504 Issued in NC
Practice address
935 4TH Street Dr NE
Hickory, NC 28601-3950
Phone
(828) 322-8710
Fax
(828) 323-8381
NPI assigned
Jul 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X 4504 NC Primary

Addresses

Primary practice location

935 4TH Street Dr NE
Hickory, NC 28601-3950

Mailing address

935 4TH Street Dr NE
Hickory, NC 28601-3950
Phone (828) 322-8710

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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

Enrollment IDStateProvider typePAC IDDetails
I20160414000800 NC Order and Referring Only - DentistPractitioner - Dentist 0042518698

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4504NCMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1639192180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "935 4TH STREET DR NE",
            "city": "HICKORY",
            "state": "NC",
            "postal_code": "286013950",
            "telephone_number": "828-322-8710",
            "fax_number": "828-323-8381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "935 4TH STREET DR NE",
            "city": "HICKORY",
            "state": "NC",
            "postal_code": "286013950",
            "telephone_number": "828-322-8710",
            "fax_number": "828-323-8381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOPP",
        "first_name": "WILLIAM",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "NC",
            "license": "4504",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hickory, NC

Sources for this page

Verify at the official NPI Registry.