Ross M Koeppen, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

25123 Issued in TX

Practice address

1671 Main St Ste B
Buda, TX 78610-9732

Phone

(512) 295-5777

Fax

(512) 295-5030

NPI assigned

Jul 2, 2007

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

Other identifiers 1

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.

• Dental Studio

  • Dentist
  • Buda, TX
  • NPI 1073834586
  NPD (past) Authorized official
• My Local Texas Dental Practice, PLLC

  dba Dental Studio

  • General Practice Dentistry
  • Buda, TX
  • NPI 1598425266
  NPD (past)

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

{
    "created_epoch": "1183334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429574400000",
    "number": "1871790964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1671 MAIN ST STE B",
            "city": "BUDA",
            "state": "TX",
            "postal_code": "786109732",
            "telephone_number": "512-295-5777",
            "fax_number": "512-295-5030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1671 MAIN ST STE B",
            "city": "BUDA",
            "state": "TX",
            "postal_code": "786109732",
            "telephone_number": "512-295-5777",
            "fax_number": "512-295-5030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOEPPEN",
        "first_name": "ROSS",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-07-02",
        "last_updated": "2015-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "25123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "213024701",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kids Tooth Team
• Maria Kindy, RD
• Kate King, CPM, LM
• KKP Ventures (Emerge Urgent Care)
• Justin Dexter Koen, DMD
• Allison Kredovski
• Jordan R Krieger, MD
• Michael Kuo, LAT, ATC
• Cliffe Khillip Kwon, M.D.
• Katelyn Lacross

• Dentist in Buda, TX
• Providers in Buda, TX by specialty
• Dentist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2015; 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.