Grace Koh, DDS

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

Practice address

1501 W Dundee Rd
#108
Buffalo Grove, IL 60089-4006

Phone

(847) 818-9950

NPI assigned

Jul 28, 2006

Sex

Female

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

Yes, effective Dec 19, 2016 through Dec 19, 2026

Medicare enrollment (NPD)

Not 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 and National Provider Directory roles.

• The Center for Periodontics & Implant Dentistry

  • Periodontics
  • Buffalo Grove, IL
  • NPI 1861762650
  NPD (past)

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1497769913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 W DUNDEE RD",
            "address_2": "#108",
            "city": "BUFFALO GROVE",
            "state": "IL",
            "postal_code": "600894006",
            "telephone_number": "847-818-9950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 W DUNDEE RD",
            "address_2": "#108",
            "city": "BUFFALO GROVE",
            "state": "IL",
            "postal_code": "600894006",
            "telephone_number": "847-818-9950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOH",
        "first_name": "GRACE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa Kleinman, PT, DPT, CLT
• Supriya N Klionsky, NP-C
• Rita R Knapp, AU.D.
• Jessie Jean Knoble, LSW
• Luiza Kofler, FNP-BC
• Dana L Kolton, MD
• Trina Marie Kolvek, RN
• Mika Kondo
• Jennifer Koriath, LCPC
• Adam Koss

• Periodontics in Buffalo Grove, IL
• Providers in Buffalo Grove, IL by specialty
• Periodontics in Illinois

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