Individual provider Active NPI

Steve Wayne Cobb, DDS

  • Dentist
  • Odessa, TX
National Provider Identifier
1104033695
Registry record updated Dec 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
11792 Issued in TX
Practice address
4208 Maple Ave
Odessa, TX 79762-7152
Phone
(432) 367-4774
Fax
(432) 550-4774
NPI assigned
May 16, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 4, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 11792 TX Primary

Addresses

Primary practice location

4208 Maple Ave
Odessa, TX 79762-7152

Mailing address

4208 Maple Ave
Odessa, TX 79762-7152
Phone (432) 367-4774

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20150720000448 TX Order and Referring Only - DentistPractitioner - Dentist 2860705985

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11792TXMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Sleep Better West Texas PLLC Dentist CurrentSince May 20, 2023 Accepting new patients

Locations

4208 Maple Ave
Odessa, TX 79762
Phone (432) 367-4774

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1179273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386115200000",
    "number": "1104033695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4208 MAPLE AVE",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797627152",
            "telephone_number": "432-367-4774",
            "fax_number": "432-550-4774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4208 MAPLE AVE",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797627152",
            "telephone_number": "432-367-4774",
            "fax_number": "432-550-4774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COBB",
        "first_name": "STEVE",
        "middle_name": "WAYNE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-16",
        "last_updated": "2013-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "11792",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Odessa, TX

Sources for this page

Verify at the official NPI Registry.