Takashi Koyama Dmd Phd Pa
Oral and Maxillofacial Dental Clinic
2402 Frist Blvd Ste 100, Fort Pierce
Florida, 34950-4838
772-461-9700 772-461-9300
Maps & DirectionsTakashi Koyama Dmd Phd Pa is a Oral and Maxillofacial Dental Clinic in Fort Pierce, Florida. It is located at 2402 Frist Blvd Ste 100, Fort Pierce, FL and its contact number is 772-461-9700. The authorized person for Takashi Koyama Dmd Phd Pa is Tanya Gonzalez
who is Practice Manager of the clinic and their contact number is 772-461-9700.
Takashi Koyama Dmd Phd Pa Clinic deals with the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.
Complete Clinic Profile:
Takashi Koyama Dmd Phd Pa Clinic speciality, address, contact phone number and fax are as below.
Patients can call on the below given phone number for appointments.
| Name: | Takashi Koyama Dmd Phd Pa |
| Specialization: | Oral and Maxillofacial Surgery |
| Clinic Address: | 2402 Frist Blvd Ste 100, Fort Pierce,
Florida, 34950-4838 |
| Phone: | 772-461-9700 |
| Fax: | 772-461-9300 |
Authorized/Official Person Profile:
Officially authorized person to contact for any management issues or complaints for this clinic are as below. Person's position and contact details are also mentioned below.
| Name: | Tanya Gonzalez |
| Position: | Practice Manager |
| Contact Number: | 772-461-9700 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details for Takashi Koyama Dmd Phd Pa clinic are as mentioned below.
| NPI Number: | 1558429753 |
| NPI Enumeration Date: | 04 Dec, 2006 |
| NPI Last Update On: | 31 Jan, 2024 |
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Takashi Koyama Dmd Phd Pa are as mentioned below.
| Specialization | License Number | State | Status | |
| Oral & Maxillofacial Surgery | | | Primary | |
| Oral and Maxillofacial Surgery | | | Secondary | |
Other Medical Identifiers:
Other legacy medical identifiers of the clinic such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
| Identifier | Type | State | Issuer |
| DN 16376 | Other | Florida | Medical License |
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | Takashi Koyama Dmd Phd Pa
2402 Frist Blvd Ste 100,
Fort Pierce, Florida |
| Zip: | 34950-4838 |
| Phone Number: | 772-461-9700 |
| Fax Number: | 772-461-9300 |
Patients can reach Takashi Koyama Dmd Phd Pa at
2402 Frist Blvd Ste 100, Fort Pierce, Florida or can
call to book an appointment on 772-461-9700.
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**Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on
08 December, 2025.