Alexander Yoo-Ahng Koh, D.D.S.

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

40164 Issued in CA

Practice address

6860 Brockton Ave Ste 4
Riverside, CA 92506-3816

Phone

(951) 686-5852

Fax

(951) 686-5853

NPI assigned

May 23, 2007

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

Enrolled in CA

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

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

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642032000000",
    "number": "1154531267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6860 BROCKTON AVE STE 4",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925063816",
            "telephone_number": "951-686-5852",
            "fax_number": "951-686-5853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6860 BROCKTON AVE STE 4",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925063816",
            "telephone_number": "951-686-5852",
            "fax_number": "951-686-5853"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOH",
        "first_name": "ALEXANDER",
        "middle_name": "YOO-AHNG",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-23",
        "last_updated": "2022-01-13",
        "certification_date": "2022-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "CA",
            "license": "40164",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cheryl Kochevar-Nolte, ASW
• Bella Kochuveli
• Neslida Kodra, DO
• Linda Koenig
• Joan Koerper, LCSW
• Janet Elizabeth Kohtz, O.D.
• Erfan Kohzadi
• Dorothy Naomi Kolb-Kishaba, LMFT
• John Koleth, MD
• Erwin Kong

• Periodontics in Riverside, CA
• Providers in Riverside, CA by specialty
• Periodontics in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2022; 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.