Cle Oms Lakewood/Rocky River - Jeffrey W. Kosman DDS Inc.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

30020221 Issued in OH

Legal business name

CLE OMS LAKEWOOD/ROCKY RIVER - JEFFREY W. KOSMAN DDS INC.

Practice address

15711 Madison Ave
Suite 104
Lakewood, OH 44107-5655

Phone

(216) 228-9000

Fax

(216) 228-8280

NPI assigned

Feb 13, 2017

Last updated

Feb 13, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Jeffrey W. Kosman, DDSNPI 1245398841

Title

Owner

Phone

(440) 934-2626

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, and the practitioner matching its NPPES authorized official.

• Jeffrey William Kosman, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Elyria, OH
  • NPI 1245398841
  Authorized official Same address or phone

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

{
    "created_epoch": "1486944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1486944000000",
    "number": "1083153985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15711 MADISON AVE",
            "address_2": "SUITE 104",
            "city": "LAKEWOOD",
            "state": "OH",
            "postal_code": "441075655",
            "telephone_number": "216-228-9000",
            "fax_number": "216-228-8280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15711 MADISON AVE",
            "address_2": "SUITE 104",
            "city": "LAKEWOOD",
            "state": "OH",
            "postal_code": "441075655",
            "telephone_number": "216-228-9000",
            "fax_number": "216-228-8280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLE OMS LAKEWOOD/ROCKY RIVER - JEFFREY W. KOSMAN DDS INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-13",
        "last_updated": "2017-02-13",
        "status": "A",
        "authorized_official_last_name": "KOSMAN",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "W.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "440-934-2626",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "OH",
            "license": "30020221",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Oral and Maxillofacial Surgery (Dentist) in Lakewood, OH
• Providers in Lakewood, OH by specialty
• Oral and Maxillofacial Surgery (Dentist) in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2017; 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.