Ben Michael Koolick, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

AZ6037 Issued in AZ

Practice address

8390 W Cactus Rd Ste 110
Peoria, AZ 85381-5206

Phone

(623) 878-3300

NPI assigned

Aug 22, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• David T. Sung, DMD, PLC

  • Dentist
  • Phoenix, AZ
  • NPI 1518308311
  NPD (past)

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

{
    "created_epoch": "1124668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1301788800000",
    "number": "1104818467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9494 E DESERT COVE AVE",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852606144",
            "telephone_number": "480-767-1338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8390 W CACTUS RD STE 110",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853815206",
            "telephone_number": "623-878-3300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOOLICK",
        "first_name": "BEN",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-22",
        "last_updated": "2011-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "AZ6037",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher Jonathan Koch, DC
• Kelsi Madelyn Kocmoud, PA-C
• Kokopelli Eye Care PC
• Marilyn A Koller, APRN, BCADM, CDE
• Anna Kondaurov
• Nathalie Koopmans
• Kylie Marie Koos, RN, BSN
• Richard M Kootman, M.D., P.C.
• Michael S. Korn, DDS
• James S Kort, MD

• General Practice Dentistry in Peoria, AZ
• Providers in Peoria, AZ by specialty
• General Practice Dentistry in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2011; 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.