Kelly Copps Wood, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

5126-015 Issued in WI

Practice address

7679 N Longview Dr
Glendale, WI 53209-1863

Phone

(262) 853-8592

Fax

(414) 464-9340

NPI assigned

Nov 1, 2006

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1851478069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7679 N LONGVIEW DR",
            "city": "GLENDALE",
            "state": "WI",
            "postal_code": "532091863",
            "telephone_number": "262-853-8592",
            "fax_number": "414-464-9340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7679 N LONGVIEW DR",
            "city": "GLENDALE",
            "state": "WI",
            "postal_code": "532091863",
            "telephone_number": "262-853-8592",
            "fax_number": "414-464-9340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOOD",
        "first_name": "KELLY",
        "middle_name": "COPPS",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "5126-015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wisconsin Dental Group, S.C.
• Wisconsin Lutheran Child & Family Service, Inc.
• Wisconsin Vision, LLC
• Elizabeth I Woger, LPC
• Christopher Wojnar, PMHNP-BC
• Rory R Wright, MD
• John C Wu, M.D.
• Dingbo Xiao, DMD
• Lee Xiong, PTA
• Nancy Xiong, LPC-IT, ATR-P

• All providers in Glendale, WI
• General Practice Dentistry in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.