Individual provider Active NPI

John Constantine Kois, DMD, MSD

  • Prosthodontics
  • Tacoma, WA
National Provider Identifier
1710083324
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ProsthodonticsTaxonomy code 1223P0700X
License
DE00005799 Issued in WA
Practice address
5615 Valley Ave E
Tacoma, WA 98424-2060
Phone
(253) 922-6056
Fax
(253) 922-3517
NPI assigned
Sep 15, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthodontics 1223P0700X DE00005799 WA Primary

Addresses

Primary practice location

5615 Valley Ave E
Tacoma, WA 98424-2060

Mailing address

5615 Valley Ave E
Tacoma, WA 98424-2060
Phone (253) 922-6056

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DE00005799WAMDProsthodontist

NPI Registry JSON

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

{
    "created_epoch": "1158278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1710083324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5615 VALLEY AVE E",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984242060",
            "telephone_number": "253-922-6056",
            "fax_number": "253-922-3517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5615 VALLEY AVE E",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984242060",
            "telephone_number": "253-922-6056",
            "fax_number": "253-922-3517"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOIS",
        "first_name": "JOHN",
        "middle_name": "CONSTANTINE",
        "name_prefix": "Dr.",
        "credential": "DMD, MSD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "WA",
            "license": "DE00005799",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

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

Verify at the official NPI Registry.