Annabel S. Koa , DMD Inc

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

ANNABEL S. KOA , DMD INC

Practice address

400 N San Mateo Dr Ste 2
San Mateo, CA 94401-2418

Phone

(650) 484-8851

NPI assigned

May 29, 2020

Last updated

May 29, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Juvith Bing Palado-Velasco

Title

Dental Biller

Phone

(650) 484-8851

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1590710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1590710400000",
    "number": "1720602444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6419 BRANDO LOOP",
            "city": "FAIR OAKS",
            "state": "CA",
            "postal_code": "956283764",
            "telephone_number": "650-278-6055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 N SAN MATEO DR STE 2",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944012418",
            "telephone_number": "650-484-8851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANNABEL S. KOA , DMD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-29",
        "last_updated": "2020-05-29",
        "certification_date": "2020-05-29",
        "status": "A",
        "authorized_official_last_name": "PALADO-VELASCO",
        "authorized_official_first_name": "JUVITH",
        "authorized_official_middle_name": "BING",
        "authorized_official_title_or_position": "DENTAL BILLER",
        "authorized_official_telephone_number": "650-484-8851"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTAL LICENSE",
            "identifier": "52877",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in San Mateo, CA
• Providers in San Mateo, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2020; 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.