NPIMap

Organization Active NPI

Cohen Modern Dentistry P.C.

  • Dentist
  • Southgate, MI
National Provider Identifier
1104288059
Registry record updated Jan 4, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2901017871 Issued in MI
Legal business name
COHEN MODERN DENTISTRY P.C.
Practice address
14420 Eureka Rd
Southgate, MI 48195-2058
Phone
(734) 283-1263
NPI assigned
Mar 21, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2017

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

Authorized official

Name
Jason M CohenNPI 1144295924
Title
Owner
Phone
(734) 283-1263

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 2901017871 MI Primary

Addresses

Primary practice location

14420 Eureka Rd
Southgate, MI 48195-2058

Mailing address

14420 Eureka Rd
Southgate, MI 48195-2058

National Provider Directory

National Provider Directory

Locations

14420 Eureka Rd
Southgate, MI 48195
Phone (734) 283-1263

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1458518400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1483488000000",
    "number": "1104288059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14420 EUREKA RD",
            "city": "SOUTHGATE",
            "state": "MI",
            "postal_code": "481952058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14420 EUREKA RD",
            "city": "SOUTHGATE",
            "state": "MI",
            "postal_code": "481952058",
            "telephone_number": "734-283-1263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COHEN MODERN DENTISTRY P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-21",
        "last_updated": "2017-01-04",
        "status": "A",
        "authorized_official_last_name": "COHEN",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "734-283-1263"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901017871",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southgate, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 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.