# JED M. KOOPS, DMD, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1558925487
- **Authorized official:** DR. JED MICHAEL KOOPS DMD (PRESIDENT)
- **Authorized official phone:** (440) 941-7824

## Contact information

- **Practice address:** 3690 ORANGE PL STE 515, BEACHWOOD, OH 44122-4466
- **Practice address phone:** (216) 464-2448
- **Mailing address:** 3028 WOODBURY RD, SHAKER HEIGHTS, OH 44120-2441
- **Mailing address phone:** (440) 941-7824

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 04/25/2019
- **Last updated:** 04/25/2019