Ryan Michael Koch, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DS044192 Issued in PA

Practice address

42 S Main St
Muncy, PA 17756-1307

Phone

(570) 546-3419

NPI assigned

Jun 28, 2023

Sex

Male

Sole proprietor

Yes

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 PA

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

Locations

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.

• Tri-Town Modern Dental

  • Dental Clinic/Center
  • Muncy, PA
  • NPI 1649015959
  NPD Authorized official

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

{
    "created_epoch": "1687910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687910400000",
    "number": "1760169122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 523",
            "city": "MC ELHATTAN",
            "state": "PA",
            "postal_code": "177480523",
            "telephone_number": "570-651-3559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42 S MAIN ST",
            "city": "MUNCY",
            "state": "PA",
            "postal_code": "177561307",
            "telephone_number": "570-546-3419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOCH",
        "first_name": "RYAN",
        "middle_name": "MICHAEL",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-06-28",
        "last_updated": "2023-06-28",
        "certification_date": "2023-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS044192",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hugh David Johnson
• Emilianna Meghan Jones
• Thomas Kalafut
• James Eric Kasenchak, M.D.
• Keystone Hook & Ladder Company No 1
• Michele Korgeski, LAT, ATC
• Lisa Koropchak
• Ernest M Laubach, DC
• Kristopher Shawn Laubach, DC
• Paul Edward Leber, M.D.

• General Practice Dentistry in Muncy, PA
• Providers in Muncy, PA by specialty
• General Practice Dentistry in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2023; 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.