DR. SUSANNE M KUPKA-MOORE D.M.D. NPI 1477677003

NPI Information

NPI: 1477677003
Provider Name: DR. SUSANNE M KUPKA-MOORE, D.M.D.
Classification: Dentist - 1223G0001X
Specialization: General Practice
Entity Type: Individual
PECOS Registration: Yes
Address: 34 DUNCAN ST
WARSAW, NY
ZIP 14569
Phone: (585) 786-3676

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NPI Details

DR. Susanne M Kupka-moore, D.M.D. is a general practice dentist in Warsaw, NY. The provider is a general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. DR. Susanne M Kupka-moore, D.M.D. NPI is 1477677003. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

34 DUNCAN ST
WARSAW, NY
ZIP 14569-017
Phone: (585) 786-3676
Fax: (585) 786-3896

The NPI 1477677003 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA).

The enumeration date for this NPI number is 3/19/2007 and was last updated on 7/9/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	1223G0001X	Dentist	General Practice	046184-1	NEW YORK	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	161350913	OTHER	NEW YORK	FEDERAL TAX ID
2	02172916	MEDICAID	NEW YORK

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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