Provider Demographics
NPI:1760535934
Name:KOENIG, HANS R (DMD)
Entity type:Individual
Prefix:DR
First Name:HANS
Middle Name:R
Last Name:KOENIG
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 W AIRPORT BLVD
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:FL
Mailing Address - Zip Code:32773-5489
Mailing Address - Country:US
Mailing Address - Phone:407-665-3345
Mailing Address - Fax:407-665-3104
Practice Address - Street 1:400 W AIRPORT BLVD
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:FL
Practice Address - Zip Code:32773-5489
Practice Address - Country:US
Practice Address - Phone:407-665-3345
Practice Address - Fax:407-665-3104
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-19
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA0368221223G0001X
FLDN184721223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice