Mark Llewellyn Kochevar, D.M.D.

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

CO6445 Issued in CO

Practice address

1513 Riverside Ave
Fort Collins, CO 80524-4348

Phone

(970) 221-5090

Fax

(970) 221-1879

NPI assigned

Jul 11, 2005

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

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Mark L. Kochevar DMD

  • Endodontics
  • Fort Collins, CO
  • NPI 1578922159
  NPD (past)

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

{
    "created_epoch": "1121040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1220313600000",
    "number": "1306844600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1513 RIVERSIDE AVE",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805244348",
            "telephone_number": "970-221-5090",
            "fax_number": "970-221-1879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1513 RIVERSIDE AVE",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805244348",
            "telephone_number": "970-221-5090",
            "fax_number": "970-221-1879"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOCHEVAR",
        "first_name": "MARK",
        "middle_name": "LLEWELLYN",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-11",
        "last_updated": "2008-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "CO",
            "license": "CO6445",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "113973800",
            "state": "WY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02064459",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Erika Andersen Ko, CLVT
• Benjamin James Harris Kober, DO
• Betsy Kaye Koch
• Kellie A Koch
• Regen J Koch
• Brittany Koehler, ATC
• Kenley Koehler
• Steven Jay Koehler, D.M.D.
• Kathleen Renee Koelsch, LPCC
• Dana Jo Koenig, RN

• Endodontics in Fort Collins, CO
• Providers in Fort Collins, CO by specialty
• Endodontics in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2008; 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.