Takashi Koyama DMD PHD PA
NPI 1558429753 · Oral & Maxillofacial Surgery (D.M.D.) · Fort Pierce, FL
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Takashi Koyama DMD PHD PA is a Oral & Maxillofacial Surgery (D.M.D.) organization in Fort Pierce, FL (NPI 1558429753).
Provider details
- NPI number
- 1558429753
- Entity type
- Organization
- Primary specialty
- Oral & Maxillofacial Surgery (D.M.D.)Allopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Tanya Gonzalez, Practice Manager(772) 461-9700
Specialties & taxonomies
Allopathic & Osteopathic Physicians
- Oral and Maxillofacial Surgery (Dentist)1223S0112X
Dental Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Other names (DBA / former)
- Doing business as
- Florida Institute of Oms
- Doing business as
- Florida Institute of Oms
Registry dates
- Enumerated
- 2006-12-04
- Last updated
- 2024-01-31
- Certified
- 2024-01-31
Frequently asked questions
- What is Takashi Koyama DMD PHD PA's NPI number?
- Takashi Koyama DMD PHD PA's National Provider Identifier (NPI) is 1558429753, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Takashi Koyama DMD PHD PA?
- Takashi Koyama DMD PHD PA is classified in the NPPES registry as Oral & Maxillofacial Surgery (D.M.D.) (Allopathic & Osteopathic Physicians).
- Where is Takashi Koyama DMD PHD PA located?
- Takashi Koyama DMD PHD PA's practice location on file with NPPES is 2402 Frist Blvd Ste 100, Fort Pierce, FL 34950-4838.
- What is Takashi Koyama DMD PHD PA's phone number?
- The practice phone number listed in the NPPES registry for Takashi Koyama DMD PHD PA is (772) 461-9700.
- Does Takashi Koyama DMD PHD PA accept Medicare?
- Takashi Koyama DMD PHD PA is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Takashi Koyama DMD PHD PA?
- The authorized official listed on Takashi Koyama DMD PHD PA's NPPES record is Tanya Gonzalez, Practice Manager. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Takashi Koyama DMD PHD PA's NPI active?
- Yes — Takashi Koyama DMD PHD PA's NPI (1558429753) is active in the NPPES registry as of the last update on 2024-01-31.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.