Liseane Koga, D.D.S.

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

LA7286 Issued in LA

Practice address

2124 Forsythe Ave
Monroe, LA 71201-3611

Phone

(318) 388-4209

NPI assigned

Feb 10, 2021

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

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

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.

• Koga Orthodontics LLC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Monroe, LA
  • NPI 1497409411
  NPD Authorized official

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

{
    "created_epoch": "1612915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650240000000",
    "number": "1447842430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2124 FORSYTHE AVE",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712013611",
            "telephone_number": "318-388-4209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2124 FORSYTHE AVE",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712013611",
            "telephone_number": "318-388-4209"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7878 Gateway Blvd E Ste 300",
            "address_purpose": "LOCATION",
            "city": "El Paso",
            "state": "TX",
            "postal_code": "799151802",
            "country_code": "US",
            "telephone_number": "915-755-7900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOGA",
        "first_name": "LISEANE",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-02-10",
        "last_updated": "2022-04-18",
        "certification_date": "2022-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "TX",
            "license": "36928",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "LA",
            "license": "LA7286",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TSBDE",
            "identifier": "36928",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LA",
            "identifier": "LA7286",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ashley Knox
• Karen Louise Koehler, DDS
• Ronald Paul Koepke, M.D.
• Hannah Koestler
• Koga Orthodontics LLC
• Jennifer Lynn Kolb, NP
• Madan Mohan Reddy Koppolu, M.D.
• Devi Meghana Kotharu
• Malorie Catherine Kraemer, LMSW
• Kramerica LLC

• Orthodontics and Dentofacial Orthopedics Dentistry in Monroe, LA
• Providers in Monroe, LA by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2022; 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.