Bryan M Konikoff, DDS

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

0401410766 Issued in VA

Practice address

477 Viking Dr
Suite 190
Virginia Beach, VA 23452-7349

Phone

(757) 486-8181

Fax

(757) 463-0148

NPI assigned

Jul 26, 2006

Last updated

Sep 6, 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

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Previously, effective Oct 8, 2012 through Oct 8, 2026

Medicare enrollment (NPD)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Konikoff Periodontics LTD

  • Periodontics
  • Virginia Beach, VA
  • NPI 1477706737
  NPD (past)

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189036800000",
    "number": "1427072404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "477 VIKING DR",
            "address_2": "SUITE 190",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234527349",
            "telephone_number": "757-486-8181",
            "fax_number": "757-463-0148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "477 VIKING DR",
            "address_2": "SUITE 190",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234527349",
            "telephone_number": "757-486-8181",
            "fax_number": "757-463-0148"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KONIKOFF",
        "first_name": "BRYAN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2007-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "VA",
            "license": "0401410766",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Konikoff Dental Associates, Inc.
• Konikoff Dental Specialists, Inc.
• Konikoff Periodontics LTD
• Albert B. Konikoff, DDS
• Alexandra Marie Konikoff
• David B Konikoff, D.D.S.
• Joshua Konikoff, D.D.S.
• Konnect Kare Residential Services
• Konnect Logistics LLC
• Kelly Koons, BCBA

• Periodontics in Virginia Beach, VA
• Providers in Virginia Beach, VA by specialty
• Periodontics in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.