Individual provider Active NPI

Brandon Cohen, D.M.D.

  • Dentist
  • Tampa, FL
National Provider Identifier
1073067542
Registry record updated Aug 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN22234 Issued in FL
Practice address
3806 W Linebaugh Ave
Tampa, FL 33618-8702
Phone
(941) 587-3432
NPI assigned
Aug 12, 2016
Last updated
Aug 12, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN22234 FL Primary

Addresses

Primary practice location

3806 W Linebaugh Ave
Tampa, FL 33618-8702

Mailing address

3721 Countryside Rd
Sarasota, FL 34233-2125

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20160930000385 FL Order and Referring Only - DentistPractitioner - Dentist 2163719444

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Networks

  • Freedom Health HMO Network

NPI Registry JSON

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

{
    "created_epoch": "1470960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470960000000",
    "number": "1073067542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3721 COUNTRYSIDE RD",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342332125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3806 W LINEBAUGH AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336188702",
            "telephone_number": "941-587-3432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COHEN",
        "first_name": "BRANDON",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-08-12",
        "last_updated": "2016-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN22234",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.