Provider Demographics
NPI:1629169057
Name:COPPS, JOANNE (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOANNE
Middle Name:
Last Name:COPPS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:RUO-YU
Other - Middle Name:
Other - Last Name:WANG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:5181 ARGONNE CT
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92117-1054
Mailing Address - Country:US
Mailing Address - Phone:858-997-7390
Mailing Address - Fax:
Practice Address - Street 1:5181 ARGONNE CT
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92117-1054
Practice Address - Country:US
Practice Address - Phone:858-997-7390
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2011-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA83941223G0001X
NE66591223G0001X
CA572671223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE47071268413Medicaid
IA0492033Medicaid