Tapan Koticha, BDS, MDS

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

72 Issued in OK

Practice address

16430 Muirfield Place
Edmond, OK 73013-9161

Phone

(405) 696-0908

NPI assigned

Dec 8, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OK

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.

• Board of Regents of the University of Oklahoma - Ou Denitstry

  • Dentist
  • Oklahoma City, OK
  • NPI 1629110119
  Medicare reassignment NPD
• Dental Specialists of Edmond

  • Prosthodontics
  • Edmond, OK
  • NPI 1699395343

  Periodontics

  NPD
• Dental Specialists of Oklahoma, PLLC

  • Prosthodontics
  • Oklahoma City, OK
  • NPI 1396559381

  Periodontics

  NPD

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

{
    "created_epoch": "1323302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702512000000",
    "number": "1497023196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16913 SHORERUN DR",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730128440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16430 MUIRFIELD PLACE",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730139161",
            "telephone_number": "405-696-0908"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1020 NW 192nd St Ste H",
            "address_purpose": "LOCATION",
            "city": "Edmond",
            "state": "OK",
            "postal_code": "730124296",
            "country_code": "US",
            "telephone_number": "405-648-8966",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOTICHA",
        "first_name": "TAPAN",
        "credential": "BDS, MDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-12-08",
        "last_updated": "2023-12-14",
        "certification_date": "2023-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901020564",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "OK",
            "license": "72",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sabina Koirala
• Alyssa Koleski
• Gene M. Koop, D.D.S.
• Kori Zibell PLLC
• Kortney Rist-Gill PHD Bcba, LLC
• Jason Kougl
• Reka Kovacs
• David P. Kowalski, LPC, BCBA
• Kelly K Kozhulenko, NP
• Melissa Diane Krause, LPC

• Periodontics in Edmond, OK
• Providers in Edmond, OK by specialty
• Periodontics in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2023; 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.