Kimberly Denton Koch, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

D13739 Issued in MN

Practice address

17597 Cedar Ave
Lakeville, MN 55044-5269

Phone

(952) 431-6606

NPI assigned

Jul 30, 2015

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

Enrolled in MN

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

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

{
    "created_epoch": "1438214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469145600000",
    "number": "1194101246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17597 CEDAR AVE",
            "city": "LAKEVILLE",
            "state": "MN",
            "postal_code": "550445269",
            "telephone_number": "952-431-6606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17597 CEDAR AVE",
            "city": "LAKEVILLE",
            "state": "MN",
            "postal_code": "550445269",
            "telephone_number": "952-431-6606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOCH",
        "first_name": "KIMBERLY",
        "middle_name": "DENTON",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-07-30",
        "last_updated": "2016-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "D13739",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Kay Klein, RN
• Lori Anne Klein, LMFT
• Shannon Klocke, RPH
• KMJV Operation LLC
• Logan Marie Knip
• Jeffery Arthur Kohler Jr., D.D.S.
• Katherine M Kohler, CRNA
• Ami Komlanvi, PA-C
• Elizabeth Tiffany Kooistra-Cass, M.S., BCBA
• Kenneth Joseph Kossack, RPH

• Dentist in Lakeville, MN
• Providers in Lakeville, MN by specialty
• Dentist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2016; 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.