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Takashi Koyama Dmd Phd PA

Oral & Maxillofacial Surgery (D.M.D.) in Fort Pierce, FL · enumerated 2006 · authorized official Tanya Gonzalez, Practice Manager.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1558429753

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Registry record

Entity type Organization (Type 2)
Legal business name Takashi Koyama Dmd Phd PA
Other name <Unavail>
Practice address 2402 Frist Blvd Ste 100, Fort Pierce, FL, 34950
Phone (772) 461-9700
Fax (772) 461-9300
Enumeration date Dec 4, 2006
Last updated in NPPES Jan 31, 2024

Taxonomy & classification

1223S0112X Oral and Maxillofacial Surgery (Dentist) Dental Providers Secondary
204E00000X Oral & Maxillofacial Surgery (D.M.D.) Allopathic & Osteopathic Physicians Primary

Authorized official

Name Tanya Gonzalez
Title Practice Manager
Phone (772) 461-9700

Other identifiers

Identifier Type State Issuer
DN 16376 Other FL MEDICAL LICENSE

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

Who is the authorized official for Takashi Koyama Dmd Phd PA?
NPPES lists Tanya Gonzalez (Practice Manager) as the authorized official for this organization.
What is the NPI number for Takashi Koyama Dmd Phd PA?
The NPI for Takashi Koyama Dmd Phd PA is 1558429753, a Type 2 (organization) record in the CMS NPPES registry.

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2024-01-31.