Individual provider Active NPI

Jacob S Cohen, DDS

  • General Practice Dentistry
  • Union City, NJ
National Provider Identifier
1124016126
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
15958 Issued in NJ
Practice address
707 Summit Ave
Union City, NJ 07087-3463
Phone
(201) 863-0816
Fax
(201) 866-3448
NPI assigned
Oct 12, 2005
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
General Practice Dentistry 1223G0001X 15958 NJ Primary

Addresses

Primary practice location

707 Summit Ave
Union City, NJ 07087-3463

Mailing address

707 Summit Ave
Union City, NJ 07087-3463
Phone (201) 863-0816

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20150702000196 NJ Order and Referring Only - DentistPractitioner - Dentist 5092027193

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
15958NJMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1129075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1124016126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "707 SUMMIT AVE",
            "city": "UNION CITY",
            "state": "NJ",
            "postal_code": "070873463",
            "telephone_number": "201-863-0816",
            "fax_number": "201-866-3448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 SUMMIT AVE",
            "city": "UNION CITY",
            "state": "NJ",
            "postal_code": "070873463",
            "telephone_number": "201-863-0816",
            "fax_number": "201-866-3448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COHEN",
        "first_name": "JACOB",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "15958",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Union City, NJ

Sources for this page

Verify at the official NPI Registry.