Kevin Coppola, DDS

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

30980 Issued in TX

Practice address

8606 Village Dr Ste B
San Antonio, TX 78217

Phone

(210) 654-6882

Fax

(210) 654-0036

NPI assigned

Jun 18, 2015

Last updated

Oct 26, 2022By the provider in NPPES

Sex

Male

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Northeast Children's Dentistry, Inc

  dba Northeast Children's Dentistry-Schertz Location

  • Pediatric Dentistry
  • Schertz, TX
  • NPI 1013563972
  NPD (past)
• Northeast Children's Dentistry, Inc

  dba Northeast Children's Dentistry-Dominion Crossing Location

  • Pediatric Dentistry
  • San Antonio, TX
  • NPI 1033765094
  NPD (past)
• Northeast Children's Dentistry, Inc

  • Pediatric Dentistry
  • San Antonio, TX
  • NPI 1245252238
  NPD (past)
• Northeast Children's Dentistry, Inc

  dba Northeast Children's Dentistry-Downtown Location

  • Pediatric Dentistry
  • San Antonio, TX
  • NPI 1356997126
  NPD (past)
• Northeast Children's Dentistry, Inc

  dba Northeast Children's Dentistry- Northern Oaks

  • Pediatric Dentistry
  • San Antonio, TX
  • NPI 1689220451
  NPD (past)

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

{
    "created_epoch": "1434585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666742400000",
    "number": "1740662477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8606 VILLAGE DR STE B",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782175506",
            "telephone_number": "210-654-6882",
            "fax_number": "210-654-0036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8606 VILLAGE DR STE B",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "78217",
            "telephone_number": "210-654-6882",
            "fax_number": "210-654-0036"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5000 Schertz Pkwy Ste 301",
            "address_purpose": "LOCATION",
            "city": "Schertz",
            "state": "TX",
            "postal_code": "781541457",
            "country_code": "US",
            "telephone_number": "210-659-8000",
            "fax_number": "210-651-9235",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4402 E. Southcross STE.101",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782227822",
            "country_code": "US",
            "telephone_number": "210-999-5475",
            "fax_number": "210-999-5387",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4358 Thousand Oaks Dr",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782172102",
            "country_code": "US",
            "telephone_number": "210-656-4300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "21727 Ih 10 W Ste 203",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782572107",
            "country_code": "US",
            "telephone_number": "210-314-4545",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "315 N San Saba Ste 202",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782073193",
            "country_code": "US",
            "telephone_number": "210-223-3383",
            "fax_number": "210-223-1055",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COPPOLA",
        "first_name": "KEVIN",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-06-18",
        "last_updated": "2022-10-26",
        "certification_date": "2022-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "TX",
            "license": "30980",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heather M Coppe
• Maria Coppersmith-Buschman, LCSW
• Tina Marie Copple, APRN
• Jacqueline Coppock, PSY.D.
• John V Coppola, DC
• William T. Coppola, DDS.
• Jonette Suzanne Coquat, LCSW, LADC
• Teresa Coral-Clark, LICSW
• Corales Dental Office
• Corazon del Valle DME LLC (Merida Health Care Group)

• Pediatric Dentistry in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Pediatric Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 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.