Provider Demographics
NPI:1003305376
Name:KUPER, TIFFNY (RHH)
Entity Type:Individual
Prefix:MRS
First Name:TIFFNY
Middle Name:
Last Name:KUPER
Suffix:
Gender:F
Credentials:RHH
Other - Prefix:MS
Other - First Name:TIFFNY
Other - Middle Name:
Other - Last Name:WICHMANN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RDH
Mailing Address - Street 1:4629 DRUM POINT LN
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23321-6143
Mailing Address - Country:US
Mailing Address - Phone:757-754-3747
Mailing Address - Fax:
Practice Address - Street 1:620 JOHN PAUL JONES CIR
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:VA
Practice Address - Zip Code:23708-2111
Practice Address - Country:US
Practice Address - Phone:757-953-2711
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-02
Last Update Date:2018-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODH.002023812124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist