Tyler Koehn, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2019045908 Issued in MO

Practice address

5901 NW 63Rd Ter Ste 150
Kansas City, MO 64151-3602

Phone

(816) 505-2222

NPI assigned

Jun 12, 2017

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 KS

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

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

{
    "created_epoch": "1497225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597968000000",
    "number": "1548790629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2301 SW 6TH AVE",
            "city": "TOPEKA",
            "state": "KS",
            "postal_code": "666061759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5901 NW 63RD TER STE 150",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641513602",
            "telephone_number": "816-505-2222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOEHN",
        "first_name": "TYLER",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-12",
        "last_updated": "2020-08-21",
        "certification_date": "2020-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KS",
            "license": "61410",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "2019045908",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sasha Caron Koch, NP
• Janelle Suzanne Kochuyt
• Madison Koczersut
• Naresh Kumar Kodwani, M.D.
• Clarie J Koehn, PHD
• Adriana Koek
• Theresa Anne Koelling, RN, BSN, MSN, FNP-C
• Bobbi Koen
• Christian Mark Koenig, PTA
• Joel F Koenig, MD

• General Practice Dentistry in Kansas City, MO
• Providers in Kansas City, MO by specialty
• General Practice Dentistry in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2020; 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.