NPIMap

Organization Active NPI

Michael F Koffler DMD Inc

  • Dental Clinic/Center
  • Petaluma, CA
National Provider Identifier
1962610550
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
25081 Issued in CA
Legal business name
MICHAEL F KOFFLER DMD INC
Practice address
131 Lynch Creek Way Ste a
Petaluma, CA 94954-2391
Phone
(707) 763-1951
NPI assigned
May 18, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Michael KofflerNPI 1851472062
Title
Owner
Phone
(707) 763-1951

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X 25081 CA Primary

Addresses

Primary practice location

131 Lynch Creek Way Ste a
Petaluma, CA 94954-2391

Mailing address

131 Lynch Creek Way Ste a
Petaluma, CA 94954-2391

National Provider Directory

National Provider Directory

Locations

131 Lynch Creek Way
Ste A
Petaluma, CA 94954
Phone (707) 763-1951

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1179446400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1962610550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "131 LYNCH CREEK WAY STE A",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "949542391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "131 LYNCH CREEK WAY STE A",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "949542391",
            "telephone_number": "707-763-1951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL F KOFFLER DMD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KOFFLER",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "707-763-1951",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "CA",
            "license": "25081",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Petaluma, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.