Mackenzie K. Lopp, DMD
Individual provider Active NPI General Practice Dentistry · Brookston, IN
NPI 1790202075 · NPPES record last updated May 24, 2023
Key facts
- NPI
- 1790202075
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 12012810A (IN)
- Practice address
- 803 S Prairie St
Brookston, IN 47923-8410 - Phone
- (765) 563-6667
- NPI assigned
- Aug 28, 2017
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12012810A | IN | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lopp Family Dental PC | Current |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 12012810A | IN | Yes |
Addresses
Primary practice location
803 S Prairie St
Brookston, IN 47923-8410
Mailing address
PO Box 158
Brookston, IN 47923-0158
Phone (765) 563-3636
Other providers in Brookston, IN
- Janelle Leslie Kennedy
- Steven L Kenyon
- Life Essentials LLC
- Lopp Family Dental PC
- Clarence Lee Lopp II
- Lizabeth Lee Marks-Shepard
- Lenard Harvey Miller
- Dianne Sue Talbot
- Tammy Louise Taylor-Walden
- Therapeutic Innovations Inc
All providers in Brookston, IN · General Practice Dentistry in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 24, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.