David M Corcoran, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Practice address

6058 Garrett LN
Rockford, IL 61107-5228

Phone

(815) 398-5610

Fax

(815) 398-8951

NPI assigned

Mar 21, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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 IL

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1063538247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6058 GARRETT LN",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611075228",
            "telephone_number": "815-398-5610",
            "fax_number": "815-398-8951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6058 GARRETT LN",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611075228",
            "telephone_number": "815-398-5610",
            "fax_number": "815-398-8951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORCORAN",
        "first_name": "DAVID",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Constance S Copeland, OD, PHD
• Danny L Copeland, MD
• Richard Terry Coppoletti, MD
• Maria Natalia Corales, LMT
• Anthony J Corbo
• Dennis Michael Corcoran, M.D.
• Lorie Anne Corcoran, APNP
• Flavio Cordano, DPM
• Kristin Cordell
• Samantha Corey

• General Practice Dentistry in Rockford, IL
• Providers in Rockford, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.