Jessica Koby, D.M.D.

Primary specialty

DentistTaxonomy code 122300000X

License

DE60691606 Issued in WA

Practice address

1148 Broadway Ste 100
Tacoma, WA 98402-3518

Phone

(253) 572-7002

NPI assigned

Jul 1, 2015

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

Enrolled in WA

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

Practice roles

Interoperability endpoints

• Direct secure messaging: jessica.kobydmd.p1@direct.chc-tacoma.nextgenshare.com

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.

• Washington Dental Corporation, PC

  • General Practice Dentistry
  • Lacey, WA
  • NPI 1992183339
  NPD (past)

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

{
    "created_epoch": "1435708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725580800000",
    "number": "1619350147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1148 BROADWAY STE 100",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984023518",
            "telephone_number": "253-572-7002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1148 BROADWAY STE 100",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984023518",
            "telephone_number": "253-572-7002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOBY",
        "first_name": "JESSICA",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-01",
        "last_updated": "2024-09-06",
        "certification_date": "2024-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE60691606",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda Sanae Mei Lin Kobayashi, DDS
• Jenny Kobayashi
• Marjorie Ann Kober, RN
• Timothy Mark Kobernik, D.O.
• Lillian H Koblenz, MD
• Lisha Danelle Koch, LMT
• Melissa M Koch
• Sandra Lou Koch, OTR
• Sarah Elizabeth Koch, MD
• Shelby Jaye Koch

• Dentist in Tacoma, WA
• Providers in Tacoma, WA by specialty
• Dentist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2024; 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.