Vrisiis Kofina, DDS

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

18301-875 Issued in WI

Practice address

1801 W Wisconsin Ave
Milwaukee, WI 53233-2186

Phone

(414) 288-5902

NPI assigned

Jul 16, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1437004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567987200000",
    "number": "1952785271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 W WISCONSIN AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532332186",
            "telephone_number": "414-288-5902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 W WISCONSIN AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532332186",
            "telephone_number": "414-288-5902"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "305 W 12th Ave",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432101267",
            "country_code": "US",
            "telephone_number": "614-292-0371",
            "fax_number": "614-292-4612",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOFINA",
        "first_name": "VRISIIS",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-16",
        "last_updated": "2019-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "WI",
            "license": "18301-875",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WI DENTAL FACULTY LICENSE",
            "identifier": "18301-875",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Raven A Koeppler, M.D.
• Kory D Koerner, M.D.
• Norman E Koerner, RPH
• David Koerten, CCP
• Mary Kofigah, 10020 - 33 NP
• Dmitriy Kogan, M.D.
• Donna Kogler, MD
• Charles H Koh, M.D.
• T C Koh, M.D.
• Amanda Joy Kohal, MS, SAC-IT

• Periodontics in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Periodontics in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.