Michael David Koerner, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

DS043703 Issued in PA

Practice address

22201 Moross
Professional Building II, Suite 155
Detroit, MI 48236

Phone

(313) 499-4775

Fax

(313) 499-4952

NPI assigned

May 25, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: michael.koerner.2@8209.direct.athenahealth.com

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

{
    "created_epoch": "1653436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747094400000",
    "number": "1124766423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22201 MOROSS",
            "address_2": "PROFESSIONAL BUILDING II, SUITE 155",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "48236",
            "telephone_number": "313-499-4775",
            "fax_number": "313-499-4952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22201 MOROSS",
            "address_2": "PROFESSIONAL BUILDING II, SUITE 155",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "48236",
            "telephone_number": "313-499-4775",
            "fax_number": "313-499-4952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOERNER",
        "first_name": "MICHAEL",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-05-25",
        "last_updated": "2025-05-13",
        "certification_date": "2025-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "PA",
            "license": null,
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS043703",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erin Koelman, LLPC
• Gerald Koenig, M.D.
• Erin Koepke, MSW
• Cole Michael Koerber, OTD
• Sean Michael Koerber, CRNA
• Ahmad Kofahi, MD
• Mikaela Kofman, DMD
• Johnene K Koganti, M.S., PA-C
• Laurie Linden Kohen, M.D.
• Heather Kohl, LLBSW

• Dentist in Detroit, MI
• Providers in Detroit, MI by specialty
• Dentist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.