Aoua Coulibaly, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

2901021822 Issued in MI

Practice address

5200 S Westnedge Ave
Portage, MI 49002-0405

Phone

(269) 382-6656

NPI assigned

Aug 5, 2008

Sex

Female

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 MI

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

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.

• Dental Dreams PLLC

  • General Practice Dentistry
  • Portage, MI
  • NPI 1093122756
  NPD (past)

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

{
    "created_epoch": "1217894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1700042165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 S WESTNEDGE AVE",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490020405",
            "telephone_number": "269-382-6656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5200 S WESTNEDGE AVE",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490020405",
            "telephone_number": "269-382-6656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COULIBALY",
        "first_name": "AOUA",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-05",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "10184",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901021822",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Core Complete
• Sarah Cormier
• Jimmie Cosby
• Jeffery Clinton Cosgrove, O.D.
• Brooklin Coss
• Courtney Ford, LLC
• Covenant Senior Day Program
• James Darrell Cowart, PH.D
• Ann E. Crabb, PHD
• Stacey Virginia Crane, LPC

• Dentist in Portage, MI
• Providers in Portage, MI by specialty
• Dentist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.