Brian Gary Cochran, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

0401410586 Issued in VA

Practice address

2 Cardinal Park Dr SE
Suite 204-a
Leesburg, VA 20175-4448

Phone

(703) 779-2296

Fax

(703) 779-0602

NPI assigned

May 9, 2007

Last updated

Jul 8, 2007By 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

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1178668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1063626422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 CARDINAL PARK DR SE",
            "address_2": "SUITE 204-A",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "201754448",
            "telephone_number": "703-779-2296",
            "fax_number": "703-779-0602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 CARDINAL PARK DR SE",
            "address_2": "SUITE 204-A",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "201754448",
            "telephone_number": "703-779-2296",
            "fax_number": "703-779-0602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COCHRAN",
        "first_name": "BRIAN",
        "middle_name": "GARY",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401410586",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "138753",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "1463842",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Walter Collazo, D.D.S.

• General Practice Dentistry in Leesburg, VA
• Providers in Leesburg, VA by specialty
• General Practice Dentistry in Virginia

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.