Lisa Jayne Koenig, BCHD, DDS, MS

Primary specialty

Oral and Maxillofacial Radiology DentistryTaxonomy code 1223X0008X

License

3846 Issued in WI

Practice address

Marquette University School of Dentistry
1801 West Wisconsin Avenue
Milwaukee, WI 53233

Phone

(414) 288-5675

Fax

(414) 288-6081

NPI assigned

Oct 3, 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 Jul 12, 2016 through Jul 12, 2028

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

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.

• Marquette University

  • Dental Hygienist
  • Milwaukee, WI
  • NPI 1467882811
  NPD (past)

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1518052174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "MARQUETTE UNIVERSITY SCHOOL OF DENTISTRY",
            "address_2": "PO BOX 1881",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532011881",
            "telephone_number": "414-288-5675",
            "fax_number": "414-288-6081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MARQUETTE UNIVERSITY SCHOOL OF DENTISTRY",
            "address_2": "1801 WEST WISCONSIN AVENUE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "53233",
            "telephone_number": "414-288-5675",
            "fax_number": "414-288-6081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOENIG",
        "first_name": "LISA",
        "middle_name": "JAYNE",
        "name_prefix": "Dr.",
        "credential": "BCHD, DDS, MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0008X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Radiology",
            "state": "WI",
            "license": "3846",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mackenzie Marie Koellermeier, MD
• Amber Koenemann
• David Steffen Koenig, DDS
• David Thomas Koenig, DO
• Halli Koenig
• Steven B Koenig, MD
• Chloe Koeppen
• Drew Koeppl, CPNP-AC
• Raven A Koeppler, M.D.
• Kory D Koerner, M.D.

• Oral and Maxillofacial Radiology Dentistry in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Oral and Maxillofacial Radiology Dentistry in Wisconsin

• 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.