Paul George Koshgerian III, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

8759 Issued in KY

Practice address

4935 Hidden River Dr
Lexington, KY 40511-9566

Phone

(859) 913-2913

NPI assigned

May 11, 2009

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 CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• 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": "1242000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1417737600000",
    "number": "1205060977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4935 HIDDEN RIVER DR",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405119566",
            "telephone_number": "859-913-2913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4935 HIDDEN RIVER DR",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405119566",
            "telephone_number": "859-913-2913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOSHGERIAN",
        "first_name": "PAUL",
        "middle_name": "GEORGE",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-05-11",
        "last_updated": "2014-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KY",
            "license": "8759",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gregory Koprowski, LPCA
• Kelsey Faulkner Korb
• Susan Tucker Kornegay
• John M. Kornet
• Catherine A Korrect, BS
• Kyle B Kosik
• Jon K Kostelic, M.D.
• Bruce Joseph Kostelnik, D.O.
• Sathish Kottaisamy, MD
• Gabrielle Lee Kotten

• General Practice Dentistry in Lexington, KY
• Providers in Lexington, KY by specialty
• General Practice Dentistry in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2014; 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.