Jeffrey Koksal, DDS

Individual provider Active NPI General Practice Dentistry · Salina, KS

NPI 1073536660 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1073536660
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
60396 (KS)
Practice address
950 Elmhurst Blvd
Salina, KS 67401-7402
Phone
(785) 827-4401
Fax
(785) 827-1560
NPI assigned
Jul 25, 2006
Sex
Male
Sole proprietor
No

Organizations & group practices 1

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.

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
60396KSMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Salina Riverside Dental Care, P. a. General Practice Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 60396 KS Yes

Addresses

Primary practice location

950 Elmhurst Blvd
Salina, KS 67401-7402

Mailing address

950 Elmhurst Blvd
Salina, KS 67401-7402
Phone (785) 827-4401

Other providers in Salina, KS

All providers in Salina, KS · General Practice Dentistry in Kansas

Sources for this page

Verify at the official NPI Registry.