Elizabeth Koo, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D010523 Issued in AZ

Practice address

2990 S 6TH Ave
Tucson, AZ 85713-4705

Phone

(520) 200-2985

NPI assigned

Feb 12, 2014

Last updated

May 1, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1392163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588291200000",
    "number": "1851715791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2990 S 6TH AVE",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857134705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2990 S 6TH AVE",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857134705",
            "telephone_number": "520-200-2985"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "630 5th Ave",
            "address_2": "Suite 1818",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "101110100",
            "country_code": "US",
            "telephone_number": "212-247-3421",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOO",
        "first_name": "ELIZABETH",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-02-12",
        "last_updated": "2020-05-01",
        "certification_date": "2020-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "057995",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "D010523",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bradley Konecnik, DMD
• Naveen Konidala
• Elise Fassler Konigsberg, WHCNP
• Julie Konigsberg, LCSW
• Bonjung Jane Koo, D.D.S.
• Gwen Marie Kooi, OTR
• Melissa G Koon, ANP
• Gerald M Koori
• Brice David Kopas, MD
• Rebecca M Kopas, MD

• General Practice Dentistry in Tucson, AZ
• Providers in Tucson, AZ by specialty
• General Practice Dentistry in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2020; 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.