DR. KOU THAO D.D.S.
NPI 1306246657
Dentist - General Practice in Minneapolis, MN

Q: What is Kou Thao's NPI number?

The NPI number for Kou Thao is 1306246657. It was assigned to this individual provider in the NPPES registry on August 22, 2014.

Q: What is Kou Thao's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Q: When was this NPI record last updated?

The NPPES record for Kou Thao was last updated on March 2, 2015. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since August 22, 2014PECOS Enrolled

636 BROADWAY ST NE, MINNEAPOLIS, MN 55413(612) 746-1530 Get Directions Write a Review

NPPES record last updated: March 2, 2015. Verified against the NPPES registry weekly; last sync: July 26, 2026.

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About Dr. Kou Thao D.d.s. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. KOU THAO D.D.S. (NPI 1306246657) is an individual general practice provider in Minneapolis, Minnesota, licensed in Minnesota (D13449) and active in the NPI registry since August 2014. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1306246657

Entity TypeIndividualMale

Primary Taxonomy1223G0001X

Provider Legal NameDR. KOU THAOCredential: D.D.S.

Location Address636 BROADWAY ST NEMinneapolis, MN 55413-2164

Mailing Address636 Broadway St NeMinneapolis, MN 55413-2164 · (612) 746-1530

Phone(612) 746-1530

Sole ProprietorNo

Enumeration DateAugust 22, 2014

Last NPPES UpdateMarch 2, 2015

✔ NPI 1306246657 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers

Taxonomy Code1223G0001X

License✔ Licensed in MN · D13449

Definition

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

636 BROADWAY ST NE, Minneapolis, MN 55413

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, BEST Life, Blue Cross and Blue Shield of Montana and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Kou Thao D.d.s. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 55413 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$85.82 typical visit price

range $56.00 – $168.28

Typical copayment $21.45 (range $14.00 – $42.07)

Most-billed visit code 99203

Established Patient

$69.74 typical visit price

range $18.32 – $138.04

Typical copayment $17.43 (range $4.58 – $34.51)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. HEATHER GLOCKLE R.D.H.

Dental Hygienist