Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. IVAN SERGEYEVICH KOUTSOPATRIY, DDS
ActiveDR. IVAN SERGEYEVICH KOUTSOPATRIY, DDS is a Pediatric Dentistry healthcare provider located in FORT BRAGG, North Carolina. NPI 1497378053 is currently active in the NPPES registry. Verify at CMS.
Pediatric Dentistry · FORT BRAGG, NC
Registration Details
- NPI Number
- 1497378053
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- May 18, 2020 (6.2157386861202 yrs)
- Last Updated
- Mar 3, 2026
- Licenses
-
30.026114 (OH)30.026114 (OH)30.026114 (OH)30.026114 (OH)
Practice Information
- Address
-
2817 ROCK MERRITT AVEWOMACK ARMY MEDICAL CENTERFORT BRAGG, NC, 283100001Browse NC providers · Browse ZIP 28310
- Phone
- 9109078922
- Primary Specialty
-
Pediatric Dentistry
1223P0700X
- Additional Specialty
- General Dentistry
- Additional Specialty
- Student (Health Education/Training)
- Additional Specialty
- Dentist
Other Pediatric Dentistry Providers in FORT BRAGG, NC
| Name | Credential | NPI |
|---|---|---|
| DR. YOUNG SUK KANG | DDS | 1215912134 |
| SIMUEL LAZAAR JAMISON | DMD | 1467438523 |
| DR. DANIEL KENT BAILEY | DDS | 1114997657 |
| DR. CHERYL MORGAN | DMD, MS, FABP | 1427019082 |
| DR. NISHA SANJAY PATEL | DMD | 1225478415 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.