Kathleen Kopecky-Groh, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DS 024851L Issued in PA

Practice address

428 Cumberland St
Lebanon, PA 17042-5314

Phone

(717) 274-2820

NPI assigned

Nov 11, 2009

Last updated

Nov 11, 2009By the provider in NPPES

Sex

Female

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

Enrolled in PA

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

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

{
    "created_epoch": "1257897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1257897600000",
    "number": "1740517804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "428 CUMBERLAND ST",
            "city": "LEBANON",
            "state": "PA",
            "postal_code": "170425314",
            "telephone_number": "717-274-2820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "428 CUMBERLAND ST",
            "city": "LEBANON",
            "state": "PA",
            "postal_code": "170425314",
            "telephone_number": "717-274-2820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOPECKY-GROH",
        "first_name": "KATHLEEN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-11-11",
        "last_updated": "2009-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS 024851L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Donald Gary Kolva, M.D.
• Amber Gwen Komykoski, CRNA
• Sirish Kumar Kondabolu
• Kevin A Koons, PHARM.D.
• Richard Kenton Koons, D C
• Christopher G Korba, PT, ATC
• Paul Koropchak, LSW
• Margarita M Kosko, MS,RDN,LDN
• Richard Lee Koslowski, D.M.D.
• Surekha Venkata Kotapothula, M.D.

• General Practice Dentistry in Lebanon, PA
• Providers in Lebanon, PA by specialty
• General Practice Dentistry in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2009; 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.