Individual provider Active NPI

William Cohen, D.M.D., M.S.

  • Periodontics
  • Saint Louis, MO
National Provider Identifier
1093737264
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
014907 Issued in MO
Practice address
777 S New Ballas Rd Ste 217W
Saint Louis, MO 63141-8717
Phone
(314) 991-7730
Fax
(314) 991-4682
NPI assigned
Jul 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X 014907 MO Primary

Addresses

Primary practice location

777 S New Ballas Rd Ste 217W
Saint Louis, MO 63141-8717

Mailing address

777 S New Ballas Rd Ste 217W
Saint Louis, MO 63141-8717
Phone (314) 991-7730

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20140627000240 MO Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 5890910210

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

NPI Registry JSON

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

{
    "created_epoch": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1093737264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 S NEW BALLAS RD STE 217W",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418717",
            "telephone_number": "314-991-7730",
            "fax_number": "314-991-4682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 S NEW BALLAS RD STE 217W",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418717",
            "telephone_number": "314-991-7730",
            "fax_number": "314-991-4682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COHEN",
        "first_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "D.M.D., M.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "MO",
            "license": "014907",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.