Provider Demographics
NPI:1609958768
Name:ROSENKOPF, KENNETH LEO (DDS)
Entity Type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:LEO
Last Name:ROSENKOPF
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 1:33 HARDING RD
Mailing Address - Street 2:
Mailing Address - City:RED BANK
Mailing Address - State:NJ
Mailing Address - Zip Code:07701-2004
Mailing Address - Country:US
Mailing Address - Phone:732-741-2771
Mailing Address - Fax:732-741-5605
Practice Address - Street 1:33 HARDING RD
Practice Address - Street 2:
Practice Address - City:RED BANK
Practice Address - State:NJ
Practice Address - Zip Code:07701-2004
Practice Address - Country:US
Practice Address - Phone:732-741-2771
Practice Address - Fax:732-741-5605
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ101651223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice