Diana Koppuzha, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

33222 Issued in TX

Practice address

20389 Interstate 35 Ste 200
Kyle, TX 78640-2039

Phone

(512) 256-8754

NPI assigned

Mar 18, 2016

Sex

Female

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

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.

• Brush32 Dental of Kyle PLLC

  • Dentist
  • Kyle, TX
  • NPI 1578912630
  NPD (past)

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

{
    "created_epoch": "1458259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1689035685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20389 INTERSTATE 35 STE 200",
            "city": "KYLE",
            "state": "TX",
            "postal_code": "786402039",
            "telephone_number": "512-256-8754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20389 INTERSTATE 35 STE 200",
            "city": "KYLE",
            "state": "TX",
            "postal_code": "786402039",
            "telephone_number": "512-256-8754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOPPUZHA",
        "first_name": "DIANA",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-18",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "33222",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kole Pierre Knutson, PA-C
• Dean Alphonse Kocay, M.D.
• Igor Borisovich Kochekovich, DC
• Kohinoor Medical Associates PA
• Taylor Sue Konynenbelt, PA-C
• Anusha Kotha, DDS
• Leah Krieg
• Vamsi Krishna, M.D.
• Kristen Tomczyszyn, Ma, LPC, LLC
• KTX Speech-Language Pathology, PLLC

• General Practice Dentistry in Kyle, TX
• Providers in Kyle, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.