Active NPI
Kevin C Kopp, DDS
- Prosthodontics
- Elmhurst, IL
National Provider Identifier
1659449775
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthodontics
- License
- 190196599
- Practice address
- 188 N York Rd
Elmhurst, IL 60126 - Phone
- (630) 941-8398
- Fax
- (630) 941-8408
- NPI assigned
- Nov 30, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Prosthodontics | 1223P0700X | 190196599 | IL | Primary |
Addresses
Primary practice location
188 N York Rd
Elmhurst, IL 60126
Mailing address
188 N York Rd
Elmhurst, IL 60126
Phone (630) 941-8398
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Jun 12, 2017 through Jun 12, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 190196599 | IL | MD | Prosthodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164844800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1344297600000",
"number": "1659449775",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "188 N YORK RD",
"city": "ELMHURST",
"state": "IL",
"postal_code": "60126",
"telephone_number": "630-941-8398",
"fax_number": "630-941-8408"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "188 N YORK RD",
"city": "ELMHURST",
"state": "IL",
"postal_code": "60126",
"telephone_number": "630-941-8398",
"fax_number": "630-941-8408"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOPP",
"first_name": "KEVIN",
"middle_name": "C",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-30",
"last_updated": "2012-08-07",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0700X",
"taxonomy_group": "",
"desc": "Dentist, Prosthodontics",
"state": "IL",
"license": "190196599",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Elmhurst, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2012; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.