Provider Demographics
NPI:1407923907
Name:KOPF, JAY JOSEPH (DDS)
Entity Type:Individual
Prefix:DR
First Name:JAY
Middle Name:JOSEPH
Last Name:KOPF
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 W 41ST ST
Mailing Address - Street 2:SUITE 404
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33140-3516
Mailing Address - Country:US
Mailing Address - Phone:305-535-1714
Mailing Address - Fax:305-535-8190
Practice Address - Street 1:400 W 41ST ST
Practice Address - Street 2:SUITE 404
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33140-3516
Practice Address - Country:US
Practice Address - Phone:305-535-1714
Practice Address - Fax:305-535-8190
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN 138921223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics