Michael J. Koufos, D.D.S.

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

8801 Issued in IN

Practice address

1630 45TH Street
Munster, IN 46321-3963

Phone

(219) 922-7257

Fax

(219) 922-7258

NPI assigned

May 8, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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 IN

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

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Nwi Orthodontics, Inc.

  dba Orthodontics, Inc.

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Munster, IN
  • NPI 1972715043
  Authorized official Same address or phone

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

{
    "created_epoch": "1178582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1336352707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1630 45TH STREET",
            "city": "MUNSTER",
            "state": "IN",
            "postal_code": "463213963",
            "telephone_number": "219-922-7257",
            "fax_number": "219-922-7258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1630 45TH STREET",
            "city": "MUNSTER",
            "state": "IN",
            "postal_code": "463213963",
            "telephone_number": "219-922-7257",
            "fax_number": "219-922-7258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOUFOS",
        "first_name": "MICHAEL",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "IN",
            "license": "8801",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jay L. Korach, M.D.
• Lisa Koscielski
• Stephan George Kossis, O.D.
• Michele Christine Kotis, NP
• Emily Barbara Koufos, DMD, MSD
• Andy Koultourides, DDS
• Diana Lynn Kovach, NP
• Joseph W. Kovach, PSYD
• Robert D Kraff, MD
• Brian J Kraus, FNP

• Orthodontics and Dentofacial Orthopedics Dentistry in Munster, IN
• Providers in Munster, IN by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.