Individual provider Active NPI

Zachary Andrew Kouri, D.D.S.

  • General Practice Dentistry
  • Des Moines, IA
National Provider Identifier
1174609846
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
08239 Issued in IA
Practice address
3830 Ingersoll Ave
Des Moines, IA 50312-3413
Phone
(515) 274-5151
Fax
(515) 274-6259
NPI assigned
Oct 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 08239 IA Primary

Addresses

Primary practice location

3830 Ingersoll Ave
Des Moines, IA 50312-3413

Mailing address

3830 Ingersoll Ave
Des Moines, IA 50312-3413
Phone (515) 274-5151

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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

Enrollment IDStateProvider typePAC IDDetails
I20160205002364 IA Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 6305140682

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
08239IAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Ingersoll Dental Group PC General Practice Past Accepting new patients

Organizations & group practices 1

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": "1161907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1174609846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3830 INGERSOLL AVE",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503123413",
            "telephone_number": "515-274-5151",
            "fax_number": "515-274-6259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3830 INGERSOLL AVE",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503123413",
            "telephone_number": "515-274-5151",
            "fax_number": "515-274-6259"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOURI",
        "first_name": "ZACHARY",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IA",
            "license": "08239",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Des Moines, IA

Sources for this page

Verify at the official NPI Registry.