Individual provider · Type 1 NPI

Ivan Sergeyevich Koutsopatriy, DDS

Prosthodontics · Fort Bragg, NC

NPI number 1497378053 Active

Practice location

2817 Rock Merritt Ave, Womack Army Medical Center
Fort Bragg, NC 28310-0001

Call (910) 907-8922 Map

Other practice locations

  • Smoke Bomb Hill Dental Clinic, Fort Bragg, NC 28310-0001 · (910) 907-8922
  • 1838 Normandy Dr, Fort Bragg, NC 28310-8503 · (191) 043-2422

Specialties and licenses

TaxonomyCodeLicense
Prosthodontics Primary 1223P0700X30.026114 (OH)
General Practice Dentistry 1223G0001X30.026114 (OH)
Student in an Organized Health Care Education/Training Program 390200000X30.026114 (OH)
Dentist 122300000X30.026114 (OH)

Prosthodontics: That branch of dentistry pertaining to the restoration and maintenance of oral functions, comfort, appearance and health of the patient by the restoration of natural teeth and/or the replacement of missing teeth and contiguous oral and maxillofacial tissues with artificial substitutes.

834 other providers at this address

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About NPI 1497378053

Ivan Sergeyevich Koutsopatriy, DDS's National Provider Identifier is 1497378053, issued on May 18, 2020. The primary taxonomy on file is Prosthodontics (1223P0700X), and the practice location is in Fort Bragg, NC. The record was last updated on Mar 3, 2026.