Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Takashi Koyama DMD PHD PA

Organization Oral and Maxillofacial Surgery (Dentist) · NPI 1558429753

Takashi Koyama DMD PHD PA is an Oral and Maxillofacial Surgery (Dentist) in Fort Pierce, Florida. Registered with an NPI since 2006.

In the registry since
2006
Specialties on file
2
What do these letters mean?
PA — Professional association
A form of business registration, not a clinical qualification.

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Practice location Address checks out

2402 Frist Blvd Ste 100
Fort Pierce, FL 34950-4838
Phone: (772) 461-9700
Fax: (772) 461-9300
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Oral & Maxillofacial Surgery (D.M.D.) (primary) Taxonomy 204E00000X
Oral and Maxillofacial Surgery (Dentist) Taxonomy 1223S0112X

Record details

NPI number1558429753
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Tanya Gonzalez — Practice Manager · (772) 461-9700
Other names Florida Institute Of Oms; Florida Institute Of Oms
NPI enumeratedDecember 4, 2006
Last updated in NPPESJanuary 31, 2024
Certification dateJanuary 31, 2024
Mailing address2402 Frist Blvd Ste 100, Fort Pierce, FL 34950-4838

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