Prof. Takashi Koyama
DMD, PHD FACS | Oral and Maxillofacial Surgeon | 25+ years Exp
2402 Frist Blvd Ste 100, Fort Pierce
Florida, 34950-4838
772-461-9700 772-461-9300
Maps & DirectionsProf. Takashi Koyama is a Fort Pierce, Florida based Oral and Maxillofacial Surgeon with
25 years of experience in
Oral and Maxillofacial Surgery. He completed his graduation from
Perelman School Of Med At The University Of Pennsylvania in 2000 He is also affiliated with hospitals like
. He accepts the Medicare-approved amount. Patients will not be billed for any more than the Medicare deductible and coinsurance. Active license number of Prof. Takashi Koyama is
DN16376 in Florida. His current practice location is
2402 Frist Blvd Ste 100, Fort Pierce. Patients can reach him at
772-461-9700.
Prof. Takashi Koyama 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 Profile:
Prof. Takashi Koyama speciality, credentials, practice address, contact phone number and fax are as below.
Patients can directly walk in or can call on the below given phone number for appointment.
| Name: | Prof. Takashi Koyama |
| Specialization: | Oral and Maxillofacial Surgeon |
| Gender: | Male |
| Credentials: | DMD, PHD FACS |
| Experience: | 25+ years |
| Medical School Attended: | Perelman School Of Med At The University Of Pennsylvania |
| Graduation Year: | 2000 |
| Accepts Medicare Assignment: | Yes |
| Practice Address: | 2402 Frist Blvd Ste 100, Fort Pierce,
Florida, 34950-4838 |
| Phone: | 772-461-9700 |
| Fax: | 772-461-9300 |
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 are as mentioned below.
| PAC ID: | 4880668417 |
| Enrollment ID: | I20040820000437 |
| NPI Number: | 1356459028 |
| NPI Enumeration Date: | 25 Aug, 2006 |
| NPI Last Update On: | 16 Jul, 2019 |
Medical Licenses:
Doctors can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Prof. Takashi Koyama are as mentioned below.
| License Number | Specialization | State | Status | |
| DN16376 | | Florida | Primary | |
| DN16376 | Oral and Maxillofacial Surgery | Florida | Secondary | |
Hospital Affiliation:
Surgeons are affiliated to many hospitals whom they worked with in the past or are presently working with. One surgeon can be affiliated to four to five hospitals at a time.
| Hospital Name (CCN) | State | Hospital Type |
| (100246) | Fort pierce, FL | Acute Care Hospital |
Other Medical Identifiers:
Other legacy medical identifiers associated with Prof. Takashi Koyama 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: | 2402 Frist Blvd Ste 100,
Fort Pierce, Florida |
| Zip: | 34950-4838 |
| Phone Number: | 772-461-9700 |
| Fax Number: | 772-461-9300 |
Patients can reach Prof. Takashi Koyama 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.