Laura C Koch Woodstock LLC Dba Fountain View Dentistry

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

LAURA C KOCH WOODSTOCK LLC DBA FOUNTAIN VIEW DENTISTRY

Practice address

1816 Eagle Drive
Building 200-a
Woodstock, GA 30189

Phone

(770) 926-0000

NPI assigned

Aug 23, 2017

Organization subpart

No

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

Authorized official

Name

Laura C. Koch, DMD

Title

Owner

Phone

(678) 428-4058

Specialties & licenses 1

Addresses

Other names 1

• dba Fountain View Dentistry Doing business as

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

{
    "created_epoch": "1503446400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1503446400000",
    "number": "1780101659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1816 EAGLE DRIVE",
            "address_2": "BUILDING 200-A",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "30189",
            "telephone_number": "770-926-0000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1816 EAGLE DRIVE",
            "address_2": "BUILDING 200-A",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "30189",
            "telephone_number": "770-926-0000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAURA C KOCH WOODSTOCK LLC DBA FOUNTAIN VIEW DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-23",
        "last_updated": "2017-08-23",
        "status": "A",
        "authorized_official_last_name": "KOCH",
        "authorized_official_first_name": "LAURA",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "678-428-4058",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "dba Fountain View Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• General Practice Dentistry in Woodstock, GA
• Providers in Woodstock, GA by specialty
• General Practice Dentistry in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2017; 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.