NPIMap

Organization Active NPI

Koga Orthodontics LLC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Monroe, LA
National Provider Identifier
1497409411
Registry record updated Feb 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
Legal business name
KOGA ORTHODONTICS LLC
Doing business as
Koga Orthodontics
Practice address
2124 Forsythe Ave
Monroe, LA 71201-3611
Phone
(318) 388-4209
NPI assigned
Feb 8, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2022

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

Authorized official

Name
Dr. Liseane Koga, DDS/MSDNPI 1447842430
Title
Orthodontist
Phone
(269) 985-8168

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223X0400X Primary

Addresses

Primary practice location

2124 Forsythe Ave
Monroe, LA 71201-3611

Mailing address

2124 Forsythe Ave
Monroe, LA 71201-3611
Phone (318) 388-4209

Other names 1

  • Koga Orthodontics Doing business as

National Provider Directory

National Provider Directory

Locations

2124 Forsythe Ave
Monroe, LA 71201
Phone (318) 388-4209

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1644278400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644278400000",
    "number": "1497409411",
    "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": [],
    "basic": {
        "organization_name": "KOGA ORTHODONTICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-08",
        "last_updated": "2022-02-08",
        "certification_date": "2022-02-08",
        "status": "A",
        "authorized_official_last_name": "KOGA",
        "authorized_official_first_name": "LISEANE",
        "authorized_official_title_or_position": "ORTHODONTIST",
        "authorized_official_telephone_number": "269-985-8168",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS/MSD"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Koga Orthodontics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Monroe, LA

Sources for this page

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