Jed M Koops, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

30.24768 Issued in OH

Practice address

3690 Orange PL Ste 515
Beachwood, OH 44122-4466

Phone

(216) 464-2448

Fax

(216) 292-2532

NPI assigned

May 27, 2016

Last updated

May 22, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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 OH

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

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.

• Jed M. Koops, DMD, LLC

  • Dental Clinic/Center
  • Beachwood, OH
  • NPI 1558925487
  NPD (past) Authorized official
• Jerome L. Faist DDS, Inc

  • General Practice Dentistry
  • Beachwood, OH
  • NPI 1942440201
  NPD (past)

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

{
    "created_epoch": "1464307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558483200000",
    "number": "1871941153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3028 WOODBURY RD",
            "city": "SHAKER HEIGHTS",
            "state": "OH",
            "postal_code": "441202441",
            "telephone_number": "216-459-7021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3690 ORANGE PL STE 515",
            "city": "BEACHWOOD",
            "state": "OH",
            "postal_code": "441224466",
            "telephone_number": "216-464-2448",
            "fax_number": "216-292-2532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOOPS",
        "first_name": "JED",
        "middle_name": "M",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-27",
        "last_updated": "2019-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30.24768",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bernadette Jean Koltz, MSPT
• Paulina Kauzljar Komso, CNP
• Stephanie A. Konesky, LPCC-S
• Ann Marie Auletta Konkoly, NP
• Kara Konrad, CNP
• Gail Kopelowitz, LISW
• Elise Malin Kopit
• Howard Kopit
• Erin Korb
• Melissa Korland, PH.D.

• General Practice Dentistry in Beachwood, OH
• Providers in Beachwood, OH by specialty
• General Practice Dentistry in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2019; 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.