Antonia Peregonov Koob, D.D.S

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

20366 Issued in TX

Practice address

2500 W Parmer LN
Suite 140
Austin, TX 78727-4233

Phone

(512) 837-6100

Fax

(512) 733-5600

NPI assigned

Aug 8, 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

Enrolled in TX

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": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1649280421",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2508 MERION CV",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786646231",
            "telephone_number": "512-238-9742",
            "fax_number": "512-733-5600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 W PARMER LN",
            "address_2": "SUITE 140",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787274233",
            "telephone_number": "512-837-6100",
            "fax_number": "512-733-5600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOOB",
        "first_name": "ANTONIA",
        "middle_name": "PEREGONOV",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "20366",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hannah Lynn Konicki
• Katarina Konradi
• Deborah Konrath
• Nikoleta Konstantoni Panousopoulou, D.D.S., M.S.D.
• William Mark Konyecsni, MD
• Heidi Joonhee Kook-Willis, AGNP-C
• Katy Eve Koonce, LCSW
• Kristen Koontz, FNP-C
• Bryan N. Koopmann, DDS
• Nikita Koottiyaniyil

• General Practice Dentistry in Austin, TX
• Providers in Austin, TX by specialty
• General Practice Dentistry in Texas

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.