BRENTON B KOCH MD NPI 1487651303

NPI Information

NPI: 1487651303
Provider Name: BRENTON B KOCH, MD
Classification: Otolaryngology - 207YS0123X
Entity Type: Individual

Specialization: Facial Plastic Surgery

Address:
4855 MILLS CIVIC PKWY # 100
WEST DES MOINES, IA
ZIP 50265
Phone: (515) 277-5555
Get Directions

Brenton B Koch, MD is a facial plastic surgery otolaryngology in West Des Moines, IA. The provider is an otolaryngologist who specializes in facial plastic surgery. Brenton B Koch, MD NPI is 1487651303. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

4855 MILLS CIVIC PKWY # 100
WEST DES MOINES, IA
ZIP 50265-268
Phone: (515) 277-5555
Fax: (515) 277-0060

The enumeration date for this NPI number is 7/7/2005 and was last updated on 3/11/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207YX0905X	Otolaryngology	Otolaryngology/Facial Plastic Surgery	31968	IOWA	No
2	2082S0099X	Plastic Surgery	Plastic Surgery Within the Head and Neck	31968	IOWA	No
3	207YS0123X	Otolaryngology	Facial Plastic Surgery	31968	IOWA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	I3915	MEDICARE ID-TYPE UNSPECIFIED	IOWA
2	G62390	MEDICARE UPIN	IOWA
3	1162586	MEDICAID	IOWA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

« Previous NPI

Next NPI »