DR. MIKAELA KOFMAN DMD
NPI 1942861612
Dentist - Oral and Maxillofacial Surgery in Detroit, MI

Q: What is Mikaela Kofman's NPI number?

The NPI number for Mikaela Kofman is 1942861612. It was assigned to this individual provider in the NPPES registry on June 24, 2019.

Q: What is Mikaela Kofman's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Surgery, with taxonomy code 1223S0112X.

Q: When was this NPI record last updated?

The NPPES record for Mikaela Kofman was last updated on August 23, 2021. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since June 24, 2019

4201 SAINT ANTOINE ST, DETROIT, MI 48201(313) 745-4697 Get Directions Write a Review

NPPES record last updated: August 23, 2021. Verified against the NPPES registry weekly; last sync: July 26, 2026.

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About Dr. Mikaela Kofman Dmd NPPES

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

DR. MIKAELA KOFMAN DMD (NPI 1942861612) is an individual oral and maxillofacial surgery provider in Detroit, Michigan, licensed in Michigan (2901600522) and active in the NPI registry since June 2019.

NPPES Registry Identity

NPI1942861612

Entity TypeIndividualFemale

Primary Taxonomy1223S0112X

Provider Legal NameDR. MIKAELA KOFMANCredential: DMD

Location Address4201 SAINT ANTOINE STDetroit, MI 48201-2153

Mailing Address3150 Woodward Ave Apt 402Detroit, MI 48201-2750 · (416) 697-2998

Phone(313) 745-4697

Sole ProprietorYes

Enumeration DateJune 24, 2019

Last NPPES UpdateAugust 23, 2021

NPPES CertifiedAugust 23, 2021

✔ NPI 1942861612 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Oral and Maxillofacial SurgeryDental Providers

Taxonomy Code1223S0112X

Licenses✔ Licensed in MI · 2901600522✔ Licensed in MI · 1741998

Definition

An oral and maxillofacial surgery dentist specialized in 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.

4201 SAINT ANTOINE ST, Detroit, MI 48201

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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP