Justin Cowan, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

107711 Issued in CA

Practice address

12419 Seal Beach Blvd
Seal Beach, CA 90740-2710

Phone

(562) 431-0393

NPI assigned

Aug 2, 2022

Last updated

Aug 2, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Bach Xuan Nguyen Dental Corporation

  dba Rossmoor Dental Group

  • General Practice Dentistry
  • Seal Beach, CA
  • NPI 1750717427
  NPD (past)

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

{
    "created_epoch": "1659398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659398400000",
    "number": "1043947906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12752 OAK WAY DR",
            "city": "LOS ALAMITOS",
            "state": "CA",
            "postal_code": "907205258",
            "telephone_number": "562-852-9082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12419 SEAL BEACH BLVD",
            "city": "SEAL BEACH",
            "state": "CA",
            "postal_code": "907402710",
            "telephone_number": "562-431-0393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COWAN",
        "first_name": "JUSTIN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-08-02",
        "last_updated": "2022-08-02",
        "certification_date": "2022-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "107711",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Joseph Constabileo, PHYSICIAN ASSISTANT
• Jennifer Leigh Contreras, LMFT
• Jeremy L Cook, DPM
• Diane Costandi, DDS
• Vitoria Cottiss, AMFT
• Mackenzie Creehan
• Cynthia D. Croslin, FNP-C
• Zachary D'Sa
• Diane Mercina Dahi, MT, FDNP, BA
• Daniel a. Herman Chiropractic, Inc

• Dentist in Seal Beach, CA
• Providers in Seal Beach, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.