Individual provider Active NPI

Robert James Koch, DMD

  • Dentist
  • Scottsdale, AZ
National Provider Identifier
1811515885
Registry record updated May 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D010703 Issued in AZ
Practice address
33739 N Scottsdale Rd Ste 101
Scottsdale, AZ 85266-1561
Phone
(480) 488-4852
NPI assigned
Jul 7, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X D010703 AZ Primary

Addresses

Primary practice location

33739 N Scottsdale Rd Ste 101
Scottsdale, AZ 85266-1561

Mailing address

33739 N Scottsdale Rd Ste 101
Scottsdale, AZ 85266-1561
Phone (480) 488-4852

Other practice location 1

1985 W Happy Valley Rd Ste 115
Phoenix, AZ 85085-2888
Phone (602) 726-1594

Other practice location 2

2236 W Bethany Home Rd Ste 1
Phoenix, AZ 85015-1934
Phone (602) 246-2217

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
D010703AZMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Desert Sage Family Dental CurrentSince Mar 13, 2022 Accepting new patients
John N Harman IV DDS BH PLLC CurrentSince Jul 19, 2020 Accepting new patients

Locations

2236 W Bethany Home Rd
Ste 1
Phoenix, AZ 85015
Phone (602) 246-2217

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1594080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620432000000",
    "number": "1811515885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33739 N SCOTTSDALE RD STE 101",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852661561",
            "telephone_number": "480-488-4852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33739 N SCOTTSDALE RD STE 101",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852661561",
            "telephone_number": "480-488-4852"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1985 W Happy Valley Rd Ste 115",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850852888",
            "country_code": "US",
            "telephone_number": "602-726-1594",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2236 W Bethany Home Rd Ste 1",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850151934",
            "country_code": "US",
            "telephone_number": "602-246-2217",
            "fax_number": "602-336-9513",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOCH",
        "first_name": "ROBERT",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-07-07",
        "last_updated": "2021-05-08",
        "certification_date": "2021-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AZ",
            "license": "D010703",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2021; 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.