Michael John Koppe, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

31487 Issued in CA

Practice address

5 Bon Air Rd Ste 114
Michael Koppe DDS
Larkspur, CA 94939-1135

Phone

(415) 924-2585

Fax

(415) 924-7455

NPI assigned

Mar 15, 2007

Last updated

Jul 8, 2007By 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

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

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1952435810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 BON AIR RD STE 114",
            "address_2": "MICHAEL KOPPE DDS",
            "city": "LARKSPUR",
            "state": "CA",
            "postal_code": "949391135",
            "telephone_number": "415-924-2585",
            "fax_number": "415-924-7455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 BON AIR RD STE 114",
            "address_2": "MICHAEL KOPPE DDS",
            "city": "LARKSPUR",
            "state": "CA",
            "postal_code": "949391135",
            "telephone_number": "415-924-2585",
            "fax_number": "415-924-7455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOPPE",
        "first_name": "MICHAEL",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "31487",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John H. Kim, PA-C
• Oana L. Klein, MD
• Claudia Knaack
• Sarah Anne Koch-Schiller, MFTI
• Sara Koenig, CPNP
• Patricia Alison Kreshin, MD
• Lindsey Kuroda, PT
• Kin Man Lai, MD
• Sarah M Lamb, RN, CNS, MS
• Sally Marie Blake Lamont, ND

• General Practice Dentistry in Larkspur, CA
• Providers in Larkspur, CA by specialty
• General Practice Dentistry in California

• 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.