Provider Demographics
NPI:1003195017
Name:COPELAND, JOI S (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOI
Middle Name:S
Last Name:COPELAND
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:JOI
Other - Middle Name:E
Other - Last Name:STALLWORTH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:2500 METROHEALTH DR
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44109-1900
Mailing Address - Country:US
Mailing Address - Phone:216-778-4725
Mailing Address - Fax:216-778-1787
Practice Address - Street 1:2500 METROHEALTH DR
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44109-1900
Practice Address - Country:US
Practice Address - Phone:216-778-4725
Practice Address - Fax:216-778-1787
Is Sole Proprietor?:No
Enumeration Date:2011-08-08
Last Update Date:2018-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN94371223G0001X
OH30.0250011223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ008499Medicaid
OH0218522Medicaid