Eric John Koren, DDS

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

30014442 Issued in OH

Practice address

3333 Burnet Ave ML 2006
Cincinnati, OH 45229

Phone

(513) 636-4641

Fax

(513) 636-8283

NPI assigned

Mar 30, 2007

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 OH

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

Practice roles

Locations

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.

• Children'S Hospital Medical Center

  • Pediatrics Physician
  • Cincinnati, OH
  • NPI 1609915784
  Medicare reassignment NPD

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

{
    "created_epoch": "1175212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705017600000",
    "number": "1437279742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3333 BURNET AVE ML 2006",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "45229",
            "telephone_number": "513-636-4641",
            "fax_number": "513-636-8283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 BURNET AVE ML 2006",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "45229",
            "telephone_number": "513-636-4641",
            "fax_number": "513-636-8283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOREN",
        "first_name": "ERIC",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-30",
        "last_updated": "2024-01-12",
        "certification_date": "2024-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "OH",
            "license": "30014442",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Calvin Korba
• Mark Andrew Korchok, D.C.
• Ali Kord, M.D., M.P.H.
• Sarah Korducki, RD,LD
• Joel L Korelitz, MD
• Jackie Marie Korenchan
• Amy B Korenyi-Both
• Krista Ann Korey, MSN, APRN, AGACNP-BC
• Thomas R Korfhagen, M.D.
• Morgan Tyler Kornblum, PT, DPT, ATC

• Pediatric Dentistry in Cincinnati, OH
• Providers in Cincinnati, OH by specialty
• Pediatric Dentistry in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2024; 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.