DR. MARK EDWARD KOONMEN DDS NPI 1326028044

NPI Information

NPI: 1326028044
Provider Name: DR. MARK EDWARD KOONMEN, DDS
Classification: Dentist - 1223P0221X
Entity Type: Individual

Specialization: Pediatric Dentistry

Address:
1122 S LINDEN RD
FLINT, MI
ZIP 48532
Phone: (810) 732-0640
Get Directions

DR. Mark Edward Koonmen, DDS is a pediatric dentistry dentist in Flint, MI. The provider is an age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. DR. Mark Edward Koonmen, DDS NPI is 1326028044. 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:

1122 S LINDEN RD
FLINT, MI
ZIP 48532-437
Phone: (810) 732-0640
Fax: (810) 732-2264

The enumeration date for this NPI number is 1/19/2006 and was last updated on 7/8/2007.

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	1223P0221X	Dentist	Pediatric Dentistry	13770	MICHIGAN	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	Other Provider Identifier Issuer
1	J801645	OTHER	MICHIGAN	BLUE CROSS AND BLUE SHIEL
2	1831730	MEDICAID	MICHIGAN

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

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