Minjin Ko, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

61448330 Issued in WA

Practice address

10303 19TH Ave SE
Everett, WA 98208-4258

Phone

(425) 357-8384

NPI assigned

Aug 31, 2023

Last updated

Aug 31, 2023By the provider in NPPES

Sex

Female

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1693440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693440000000",
    "number": "1184400681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13837 SE 62ND ST",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980064806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10303 19TH AVE SE",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982084258",
            "telephone_number": "425-357-8384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KO",
        "first_name": "MINJIN",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-08-31",
        "last_updated": "2023-08-31",
        "certification_date": "2023-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "61448330",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ladonna Lea Knutsen, PTA
• Jovette Vanice Knutson Hays
• Alan Ko, RN
• Brittany Ko, PTA
• Caleb Kekahu Ko, MD
• Selena Kobelt, MT
• Jennifer E Kociaj, OTR/L
• Kari Lynne Kockler, PT
• Kavyashri Kodlipet Jagadeesh, MD
• Ashley Marie Koeffler

• General Practice Dentistry in Everett, WA
• Providers in Everett, WA by specialty
• General Practice Dentistry in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2023; 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.