Individual provider Active NPI

Jana-Marie Danielle Koylass, D.D.S.

  • Periodontics
  • San Antonio, TX
National Provider Identifier
1043494420
Registry record updated Dec 21, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
UTSA 756X Issued in TX
Practice address
7703 Floyd Curl Dr
Department of Periodontics
San Antonio, TX 78229-3901
Phone
(210) 567-3589
NPI assigned
Dec 21, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 21, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X UTSA 756X TX Primary

Addresses

Primary practice location

7703 Floyd Curl Dr
Department of Periodontics
San Antonio, TX 78229-3901

Mailing address

5623 Hamilton Wolfe
1224
San Antonio, TX 78240-3991
Phone (210) 567-3318

Other identifiers 1

IdentifierTypeStateIssuer
20142555OtherUTSA 756X

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
UTSA 756XTXMDPeriodontist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1198195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1198195200000",
    "number": "1043494420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5623 HAMILTON WOLFE",
            "address_2": "1224",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782403991",
            "telephone_number": "210-567-3318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7703 FLOYD CURL DR",
            "address_2": "DEPARTMENT OF PERIODONTICS",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293901",
            "telephone_number": "210-567-3589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOYLASS",
        "first_name": "JANA-MARIE",
        "middle_name": "DANIELLE",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-12-21",
        "last_updated": "2007-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "TX",
            "license": "UTSA 756X",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UTSA 756X",
            "identifier": "20142555",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.