Provider Demographics
NPI:1356046189
Name:POPCAKOVA, FATIMA (DDS)
Entity type:Individual
Prefix:
First Name:FATIMA
Middle Name:
Last Name:POPCAKOVA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1352 CROSSING WAY
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07470-4741
Mailing Address - Country:US
Mailing Address - Phone:201-970-6262
Mailing Address - Fax:
Practice Address - Street 1:1055 HAMBURG TPKE
Practice Address - Street 2:
Practice Address - City:WAYNE
Practice Address - State:NJ
Practice Address - Zip Code:07470-3235
Practice Address - Country:US
Practice Address - Phone:973-696-5444
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-03
Last Update Date:2024-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI03043700122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist