Cosmetic Dentistry Inc

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DS035349 Issued in PA

Legal business name

COSMETIC DENTISTRY INC

Practice address

110 Radnor Rd
Suite 200
State College, PA 16801-7987

Phone

(814) 238-2020

NPI assigned

Jul 7, 2014

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Robert Leon Jeanmenne, DDSNPI 1730247933

Title

Owner, President

Phone

(814) 238-2020

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Robert Leon Jeanmenne, D.D.S.

  • General Practice Dentistry
  • State College, PA
  • NPI 1730247933
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1404691200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1404691200000",
    "number": "1043626450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 RADNOR RD",
            "address_2": "SUITE 200",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168017987",
            "telephone_number": "814-238-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 RADNOR RD",
            "address_2": "SUITE 200",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168017987",
            "telephone_number": "814-238-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COSMETIC DENTISTRY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-07",
        "last_updated": "2014-07-07",
        "status": "A",
        "authorized_official_last_name": "JEANMENNE",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "LEON",
        "authorized_official_title_or_position": "OWNER, PRESIDENT",
        "authorized_official_telephone_number": "814-238-2020",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS035349",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda M. Cordero, PA-C
• Tyler Mark Corle, PHARMD
• John Mansfield Corneal III, DC
• Manuel Corona, PT, DPT, LAT, ATC
• Dylan Alexander Corp, PHD
• Annamarie C Costlow, PA-C
• Counseling Alternatives Group, Inc
• Phuong Tran Courtney, PA
• Thomas E Covaleski, M.D.
• Michael Gene Covone

• General Practice Dentistry in State College, PA
• Providers in State College, PA by specialty
• General Practice Dentistry in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.