DR. IVAN SERGEYEVICH KOUTSOPATRIY DDS
NPI 1497378053
Dentist - Prosthodontics in Fort Bragg, NC

Q: What is Ivan Koutsopatriy's NPI number?

The NPI number for Ivan Koutsopatriy is 1497378053. It was assigned to this individual provider in the NPPES registry on May 18, 2020.

Q: What is Ivan Koutsopatriy's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Prosthodontics, with taxonomy code 1223P0700X.

Q: When was this NPI record last updated?

The NPPES record for Ivan Koutsopatriy was last updated on March 3, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since May 18, 2020

2817 ROCK MERRITT AVE, WOMACK ARMY MEDICAL CENTER, FORT BRAGG, NC 28310(910) 907-8922 Get Directions Write a Review

NPPES record last updated: March 3, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Mar 3, 2026, Aug 8, 2023, Jul 17, 2023 and 3 more (6 updates tracked since 2020).

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About Dr. Ivan Sergeyevich Koutsopatriy Dds NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. IVAN SERGEYEVICH KOUTSOPATRIY DDS (NPI 1497378053) is an individual prosthodontics provider in Fort Bragg, North Carolina, licensed in Ohio (30.026114) and active in the NPI registry since May 2020. He maintains 2 additional practice locations.

NPPES Registry Identity

NPI1497378053

Entity TypeIndividualMale

Primary Taxonomy1223P0700X

Provider Legal NameDR. IVAN SERGEYEVICH KOUTSOPATRIYCredential: DDS

Location Address2817 ROCK MERRITT AVE, WOMACK ARMY MEDICAL CENTERFort Bragg, NC 28310-0001

Mailing Address2817 Rock Merritt Ave, Womack Army Medical CenterFort Bragg, NC 28310-0001 · (910) 907-8922

Phone(910) 907-8922

Sole ProprietorNo

Enumeration DateMay 18, 2020

Last NPPES UpdateMarch 3, 20266 updates tracked since enumeration

NPPES CertifiedMarch 3, 2026

✔ NPI 1497378053 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyDentist · ProsthodonticsDental Providers

Taxonomy Code1223P0700X

License✔ Licensed in OH · 30.026114

Definition

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.

Also ListedDentistTaxonomy 122300000X · License 30.026114 (OH)

Also ListedDentist · General PracticeTaxonomy 1223G0001X · License 30.026114 (OH)

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X · License 30.026114 (OH)

2817 ROCK MERRITT AVE, Fort Bragg, NC 28310

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Secondary Practice Locations 2

Location 1Smoke Bomb Hill Dental ClinicFort Bragg, NC 28310-0001 · Phone (910) 907-8922

Location 21838 Normandy DrFort Bragg, NC 28310-8503 · Phone (191) 043-2422

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JOSEPH CLAIR

Nurse Anesthetist, Certified Registered

2817 ROCK MERRITT AVE, WOMACK ARMY MEDICAL CENTER
FORT BRAGG, NC 28310

Cumberland County (910) 907-8922

DR. ROBERT JOSEPH ROLLER JR. PT, PHD, DPT, ATC

Physical Therapist (Sports)

2817 ROCK MERRITT AVE
FORT BRAGG, NC 28310

Cumberland County (910) 907-8922

ERIN FOLEY PT, DPT

Physical Therapist

2817 ROCK MERRITT AVE
FORT BRAGG, NC 28310

Cumberland County (910) 907-8709

MICHAEL ANDREW SLACK DPT

Physical Therapist

2817 ROCK MERRITT AVE
FORT BRAGG, NC 28310

Cumberland County (224) 715-1689

MRS. COLLEEN MARGARET REMINSKY LAT, ATC

Specialist/Technologist (Athletic Trainer)

2817 ROCK MERRITT AVE
FORT BRAGG, NC 28310

Cumberland County (910) 908-9663

ROBERT AUSTIN JONES PA-C

Physician Assistant

2817 ROCK MERRITT AVE
FORT LIBERTY, NC 28310

Cumberland County (910) 907-8922

JUSTINA JEAN AHN DMD

Dentist

2817 ROCK MERRITT AVE
FORT BRAGG, NC 28310

Cumberland County (910) 907-8922

JOSEPH PAUL BRITVEN

Student in an Organized Health Care Education/Training Program

2817 ROCK MERRITT AVE
FORT BRAGG, NC 28310

Cumberland County (910) 907-7698

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Ivan Koutsopatriy's NPI number?

The NPI number for Ivan Koutsopatriy is 1497378053. It was assigned to this individual provider in the NPPES registry on May 18, 2020.

Where is Ivan Koutsopatriy located?

Ivan Koutsopatriy practices at 2817 Rock Merritt Ave Womack Army Medical Center, Fort Bragg, NC 28310. The listed phone number is (910) 907-8922.

What is Ivan Koutsopatriy's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Prosthodontics, with taxonomy code 1223P0700X.

When was this NPI record last updated?

The NPPES record for Ivan Koutsopatriy was last updated on March 3, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.