Provider Demographics
NPI:1891858049
Name:YVONNE KINKOPF DDS INC
Entity Type:Organization
Organization Name:YVONNE KINKOPF DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:YVONNE
Authorized Official - Middle Name:BILO
Authorized Official - Last Name:KINKOPF
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:216-321-6600
Mailing Address - Street 1:14100 CEDAR RD
Mailing Address - Street 2:#200
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44121-3212
Mailing Address - Country:US
Mailing Address - Phone:216-382-6600
Mailing Address - Fax:216-382-5066
Practice Address - Street 1:20620 N PARK BLVD
Practice Address - Street 2:#214
Practice Address - City:SHAKER HIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44118
Practice Address - Country:US
Practice Address - Phone:216-321-6600
Practice Address - Fax:216-321-6634
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-19
Last Update Date:2008-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH300212641223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty