Individual provider Active NPI

Heather Renee Koch, D.D.S

  • Dentist
  • Mustang, OK
National Provider Identifier
1124349659
Registry record updated Jun 18, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
6195 Issued in OK
Practice address
1041 E State Highway 152
Mustang, OK 73064-5117
Phone
(405) 256-0037
NPI assigned
Jun 18, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 6195 OK Primary

Addresses

Primary practice location

1041 E State Highway 152
Mustang, OK 73064-5117

Mailing address

508 SW 123Rd PL
Oklahoma City, OK 73170-6040
Phone (405) 640-5458

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
6195OKMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Heather R Koch DDS PLLC Dentist Past Accepting new patients
Okc Dental Health Associates, P.C. Past Accepting new patients

Organizations & group practices 2

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": "1276819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1276819200000",
    "number": "1124349659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "508 SW 123RD PL",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731706040",
            "telephone_number": "405-640-5458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1041 E STATE HIGHWAY 152",
            "city": "MUSTANG",
            "state": "OK",
            "postal_code": "730645117",
            "telephone_number": "405-256-0037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOCH",
        "first_name": "HEATHER",
        "middle_name": "RENEE",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-18",
        "last_updated": "2010-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OK",
            "license": "6195",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mustang, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2010; 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.