Lisa M Kotch DMD PC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

LISA M KOTCH DMD PC

Practice address

333 Wyoming Ave
Kingston, PA 18704-3502

Phone

(570) 714-8083

NPI assigned

Apr 2, 2008

Last updated

Apr 2, 2008By 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

Lisa M Kotch, DMD

Title

President

Phone

(570) 714-8073

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1207094400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207094400000",
    "number": "1790958437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 WYOMING AVE",
            "city": "KINGSTON",
            "state": "PA",
            "postal_code": "187043502",
            "telephone_number": "570-714-8083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 WYOMING AVE",
            "city": "KINGSTON",
            "state": "PA",
            "postal_code": "187043502",
            "telephone_number": "570-714-8083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LISA M KOTCH DMD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-02",
        "last_updated": "2008-04-02",
        "status": "A",
        "authorized_official_last_name": "KOTCH",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "570-714-8073",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2008; 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.