NPIMap

Individual provider Active NPI

Richard C Koyomji

  • Dentist
  • Bethesda, MD
National Provider Identifier
1821208646
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
12381 Issued in MD
Practice address
8218 Wisconsin Ave
Suite 200
Bethesda, MD 20814-3107
Phone
(301) 654-1111
Fax
(301) 654-2227
NPI assigned
May 23, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 12381 MD Primary

Addresses

Primary practice location

8218 Wisconsin Ave
Suite 200
Bethesda, MD 20814-3107

Mailing address

8218 Wisconsin Ave
Suite 200
Bethesda, MD 20814-3107
Phone (301) 654-1111

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
12381MDMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Bethesda Aesthetic Dentistry LLC Past Accepting new patients
Koyomji Dental Past Accepting new patients

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": "1179878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1821208646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8218 WISCONSIN AVE",
            "address_2": "SUITE 200",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208143107",
            "telephone_number": "301-654-1111",
            "fax_number": "301-654-2227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8218 WISCONSIN AVE",
            "address_2": "SUITE 200",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208143107",
            "telephone_number": "301-654-1111",
            "fax_number": "301-654-2227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOYOMJI",
        "first_name": "RICHARD",
        "middle_name": "C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MD",
            "license": "12381",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethesda, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.