Active NPI
Darren Gregory Koch, DDS
- General Practice Dentistry
- Cary, NC
National Provider Identifier
1104854074
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 7372
- Practice address
- 100 Parkway Office CT #204
Cary, NC 27518 - Phone
- (919) 859-6633
- Fax
- (919) 859-6644
- NPI assigned
- Jun 29, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 7372 | NC | Primary |
Addresses
Primary practice location
100 Parkway Office CT #204
Cary, NC 27518
Mailing address
100 Parkway Office CT #204
Cary, NC 27518-7438
Phone (919) 859-6633
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 89902T9 | Medicaid | NC |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 7372 | NC | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151539200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1524787200000",
"number": "1104854074",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 PARKWAY OFFICE CT #204",
"city": "CARY",
"state": "NC",
"postal_code": "275187438",
"telephone_number": "919-859-6633",
"fax_number": "919-859-6644"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 PARKWAY OFFICE CT #204",
"city": "CARY",
"state": "NC",
"postal_code": "27518",
"telephone_number": "919-859-6633",
"fax_number": "919-859-6644"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOCH",
"first_name": "DARREN",
"middle_name": "GREGORY",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-29",
"last_updated": "2018-04-27",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "NC",
"license": "7372",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "89902T9",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Cary, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.