Jacob Kaopua, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D012583 Issued in AZ

Practice address

1240 E Baseline Rd Ste 100
Mesa, AZ 85204-6700

Phone

(480) 576-7378

NPI assigned

Jul 15, 2025

Last updated

Jul 15, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Enrolled in AZ

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

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Mesa Grand Kids Dentistry and Orthodontics Az LLP

  dba Mesa Grand Dental Group

  • General Practice Dentistry
  • Mesa, AZ
  • NPI 1912649807
  NPD

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

{
    "created_epoch": "1752537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752537600000",
    "number": "1669364725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "435 E MAIN ST APT 241",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852035145",
            "telephone_number": "360-202-7368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1240 E BASELINE RD STE 100",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852046700",
            "telephone_number": "480-576-7378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAOPUA",
        "first_name": "JACOB",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-07-15",
        "last_updated": "2025-07-15",
        "certification_date": "2025-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "D012583",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Roopesh K Kantala, M.D.
• Thomas John Kantaras
• Kelly L. Kantartzis, MD
• Patricia Kao-Hutt, MA, CCC-A
• Jonathan B. Kao, MD
• Sasha Viren Kapadia
• Andrew J. Kaplan, M.D.
• Mark Kaplunovsky
• Catherine Craver Kapoor, MD
• Kelly Kapp, OTR-L

• General Practice Dentistry in Mesa, AZ
• Providers in Mesa, AZ by specialty
• General Practice Dentistry in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2025; 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.