Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Ivan Sergeyevich Koutsopatriy, DDS

Individual provider Prosthodontics · NPI 1497378053

Dr. Ivan Sergeyevich Koutsopatriy, DDS is a Prosthodontics in Fort Bragg, North Carolina. Works from 3 locations. Licensed in Ohio.

Licensed in
OH
In the registry since
2020
Specialties on file
4
What do these letters mean?
DDS — Doctor of Dental Surgery
A dentist. DDS and DMD are the same qualification — universities choose which title to award.

See every abbreviation used in this directory →

Practice location Address checks out

2817 Rock Merritt Ave Womack Army Medical Ctr
Fort Bragg, NC 28310-0001
Phone: (910) 907-8922
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 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 & licences

Prosthodontics (primary) Taxonomy 1223P0700X · Licence 30.026114 (OH)
General Practice Dentistry Taxonomy 1223G0001X · Licence 30.026114 (OH)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X · Licence 30.026114 (OH)
Dentist Taxonomy 122300000X · Licence 30.026114 (OH)

Record details

NPI number1497378053
Entity typeIndividual (Type 1)
GenderMale
Credentials DDS
Sole proprietorNo
NPI enumeratedMay 18, 2020
Last updated in NPPESMarch 3, 2026
Certification dateMarch 3, 2026
Mailing address2817 Rock Merritt Ave, Womack Army Medical Center, Fort Bragg, NC 28310-0001

Other providers in Fort Bragg