Daniel Gregory Koman, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D011111 Issued in AZ

Practice address

3668 West Anthem Way
#162
Anthem, AZ 85086

Phone

(623) 551-7500

Fax

(623) 551-5175

NPI assigned

May 22, 2020

Last updated

Aug 5, 2021By the provider in NPPES

Sex

Male

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

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Anthem Dentistry LLC

  • Dentist
  • Anthem, AZ
  • NPI 1770598161
  NPD

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

{
    "created_epoch": "1590105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628121600000",
    "number": "1942823182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34225 N 27TH DRIVE",
            "address_2": "BLDG 5 ST 241",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850856091",
            "telephone_number": "623-439-2280",
            "fax_number": "626-289-2578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3668 WEST ANTHEM WAY",
            "address_2": "#162",
            "city": "ANTHEM",
            "state": "AZ",
            "postal_code": "85086",
            "telephone_number": "623-551-7500",
            "fax_number": "623-551-5175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOMAN",
        "first_name": "DANIEL",
        "middle_name": "GREGORY",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-05-22",
        "last_updated": "2021-08-05",
        "certification_date": "2021-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "30.026113",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "D011111",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ida Kargar
• Mikaela Elyse Kirby, OTD, OTR/L
• Stephen Kittridge, LCSW
• Robert Bradley Kohl, DDS
• Tatum Kolicko
• La Pietra Geralyn La Pietra, M.S., CCC-SLP
• Candice Mae Lancaster, DPT
• Landmark Medical LLC
• George Langford
• Lasting Smiles of Anthem LLC

• General Practice Dentistry in Anthem, AZ
• Providers in Anthem, 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 Aug 5, 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.