Provider Demographics
NPI:1639250236
Name:DAVID A. KOENIG DDS, PA
Entity Type:Organization
Organization Name:DAVID A. KOENIG DDS, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:A
Authorized Official - Last Name:KOENIG
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:973-535-0800
Mailing Address - Street 1:2 W NORTHFIELD RD
Mailing Address - Street 2:SUITE 210B
Mailing Address - City:LIVINGSTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07039-3789
Mailing Address - Country:US
Mailing Address - Phone:973-535-0800
Mailing Address - Fax:973-535-8783
Practice Address - Street 1:2 W NORTHFIELD RD
Practice Address - Street 2:SUITE 210B
Practice Address - City:LIVINGSTON
Practice Address - State:NJ
Practice Address - Zip Code:07039-3789
Practice Address - Country:US
Practice Address - Phone:973-535-0800
Practice Address - Fax:973-535-8783
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI126111223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty