Hillary Koh, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D010445 Issued in AZ

Practice address

3264 N Glassford Hill Rd Ste a
Prescott Valley, AZ 86314-1353

Phone

(928) 759-8000

NPI assigned

Mar 29, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in AZ

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

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.

• Edward M. Reifman, DDS Inc

  • Dentist
  • Prescott Valley, AZ
  • NPI 1750623559
  NPD (past)
• Prescott Valley Dental Group, LLP

  dba Prescott Valley Dental Group

  • Dentist
  • Prescott Valley, AZ
  • NPI 1932518404
  NPD (past)

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

{
    "created_epoch": "1553817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593993600000",
    "number": "1710448956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15446 N GREENWAY HAYDEN LOOP UNIT 3073",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852603148",
            "telephone_number": "650-867-2261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3264 N GLASSFORD HILL RD STE A",
            "city": "PRESCOTT VALLEY",
            "state": "AZ",
            "postal_code": "863141353",
            "telephone_number": "928-759-8000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "839 W Congress St",
            "address_purpose": "LOCATION",
            "city": "Tucson",
            "state": "AZ",
            "postal_code": "85745",
            "country_code": "US",
            "telephone_number": "520-670-3909",
            "fax_number": "520-309-2560",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOH",
        "first_name": "HILLARY",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-03-29",
        "last_updated": "2020-07-06",
        "certification_date": "2020-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "D010445",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "prescottvalleydentalgroup.com",
            "affiliation": "N",
            "endpointDescription": "practice website",
            "address_1": "3264 N Glassford Hill Rd Ste A",
            "city": "Prescott Valley",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "863141353",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Amy S Kille, PHARM.D.
• Seonjeong Kim
• Kin Care LLC
• Carrie Kinsey, CPM
• Roberta Knowles
• Kokopelli Eye Care Optical Dept
• Kokopelli Eye Care PC
• Kokopelli Eye Care PC (Kokopelli Eye Institute)
• Kokopelli Eye Care Surgery Center
• Taja Kolack, RN

• General Practice Dentistry in Prescott Valley, AZ
• Providers in Prescott Valley, AZ by specialty
• General Practice Dentistry in Arizona

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