Kyung Seok Ko, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

11214 Issued in CT

Practice address

194 Buckland Hills Dr
Manchester, CT 06042-8705

Phone

(860) 644-0099

NPI assigned

Jul 2, 2014

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

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": "1404259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479686400000",
    "number": "1972919686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "194 BUCKLAND HILLS DR",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "060428705",
            "telephone_number": "860-644-0099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "194 BUCKLAND HILLS DR",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "060428705",
            "telephone_number": "860-644-0099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KO",
        "first_name": "KYUNG SEOK",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-07-02",
        "last_updated": "2016-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "11214",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS040607",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "058900",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Douglas C Klotzer, LCSW
• John Knecht
• Christine M Knight, PT
• Kayann Knight
• Monique D Knighton
• Julianna V Kocenski
• Joseph Peter Kocot, PA-C
• Glenn Koehler, D.D.S.
• Rebecca Koerber
• Kristin Marie Kolat, APRN

• General Practice Dentistry in Manchester, CT
• Providers in Manchester, CT by specialty
• General Practice Dentistry in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2016; 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.