Thomas E Koertge, D.M.D.

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

0401006156 Issued in VA

Practice address

521 N 11TH Street
Dental Faculty Practice
Richmond, VA 23298-0566

Phone

(804) 828-3368

NPI assigned

Mar 8, 2006

Last updated

Jul 13, 2026By 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 1

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

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": "1141776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1972571909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "521 N 11TH STREET",
            "address_2": "DEPARTMENT OF PERIODONTICS",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232980566",
            "telephone_number": "804-828-7952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "521 N 11TH STREET",
            "address_2": "DENTAL FACULTY PRACTICE",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232980566",
            "telephone_number": "804-828-3368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOERTGE",
        "first_name": "THOMAS",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-08",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "VA",
            "license": "0401006156",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Kocik, LPC
• Ellen Koduah-Agbo, DNP, APRN, PMHNP-BC
• Jenna Ann Koehler, FNP-C
• Deborah Ann Koehn, MD
• Karl G Koenig, M.D.
• Christopher Paul Kogut, MD, MSW
• Susan M Kohler LPC LLC, LPC
• Jennifer Koide
• Shanti Koirala Pradhan, M.D.
• Alexander Stephen Kolar, DNP, CRNA

• Periodontics in Richmond, VA
• Providers in Richmond, VA by specialty
• Periodontics in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.