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NPI Code Detail

MEDICARE: DR. EMILY SUZANNE KOPEC DDS

MEDICARE: DR. EMILY SUZANNE KOPEC DDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice DentistryDDS-09568IA

General Provider Information

NPI Number : 1134612070
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. EMILY SUZANNE KOPEC DDS
Provider Business Mailing Address
First Line : 816 BUCK ST
Second Line :
City : TIFFIN
State : IA
Zip : 52340-9419
Country : US
Telephone Number : 319-360-1262
Fax Number :
Provider Business Practice Location Address
First Line : 4150 EDGEWOOD RD NE STE 150
Second Line :
City : CEDAR RAPIDS
State : IA
Zip : 52402-7107
Country : US
Telephone Number : 319-360-1262
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/13/2018
Last Update Date : 05/06/2025

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