Individual provider Active NPI

Laura Colman Koch, D.M.D.

  • Dentist
  • Atlanta, GA
National Provider Identifier
1063500635
Registry record updated Jan 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN010803 Issued in GA
Practice address
1401 Peachtree St NE Ste 100
Atlanta, GA 30309-3005
Phone
(404) 249-1716
Fax
(404) 249-1716
NPI assigned
Oct 10, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN010803 GA Primary

Addresses

Primary practice location

1401 Peachtree St NE Ste 100
Atlanta, GA 30309-3005

Mailing address

1401 Peachtree St NE Ste 100
Atlanta, GA 30309-3005
Phone (404) 249-1716

Other practice location 1

1299 Russell Pkwy
Warner Robins, GA 31088-5582
Phone (478) 923-6449

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
DN010803GAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Dentistry for Midtown, LLC Dentist Current Accepting new patients
Dentistry of Norcross LLC General Practice CurrentSince Mar 12, 2023 Accepting new patients
Dentistry for Warner Robins, P.C. Dentist Past Accepting new patients
Koch & Crossley LLC Dentist Past Accepting new patients
David H. Doggett Bordeaux DDS LLC Dentist Past Accepting new patients

Locations

1401 Peachtree St NE
Ste 100
Atlanta, GA 30309
Phone (404) 249-1716

855 Juniper St NE
Atlanta, GA 30308
Phone (404) 249-1716

6063 Peachtree Pkwy
Ste 201B
Norcross, GA 30092
Phone (404) 934-2294

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673308800000",
    "number": "1063500635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 PEACHTREE ST NE STE 100",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303093005",
            "telephone_number": "404-249-1716",
            "fax_number": "404-249-1716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 PEACHTREE ST NE STE 100",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303093005",
            "telephone_number": "404-249-1716",
            "fax_number": "404-249-1716"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1299 Russell Pkwy",
            "address_purpose": "LOCATION",
            "city": "Warner Robins",
            "state": "GA",
            "postal_code": "310885582",
            "country_code": "US",
            "telephone_number": "478-923-6449",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOCH",
        "first_name": "LAURA",
        "middle_name": "COLMAN",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-10",
        "last_updated": "2023-01-10",
        "certification_date": "2023-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "GA",
            "license": "DN010803",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2023; 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.