Individual provider Active NPI

John Cohen, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Lennox, CA
National Provider Identifier
1154492379
Registry record updated Oct 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
40423 Issued in CA
Practice address
10823 Hawthorne Blvd Ste a
Lennox, CA 90304-4322
Phone
(818) 786-6000
Fax
(818) 786-8820
NPI assigned
Nov 10, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 13, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 40423 CA
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 40423 CA Primary

Addresses

Primary practice location

10823 Hawthorne Blvd Ste a
Lennox, CA 90304-4322

Mailing address

10823 Hawthorne Blvd Ste a
Lennox, CA 90304-4322
Phone (818) 786-6000

Other identifiers 1

IdentifierTypeStateIssuer
B40423-01OtherCADENTICAL PROVIDER NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20201008000780 CA Practitioner - Oral SurgeryPractitioner - Dentist 0143648881

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
40423CAMDLicensed Psychiatric Technician

Practice roles

OrganizationSpecialtyStatusNew patients
John Cohen D D S Dental Corporation CurrentSince Aug 1, 2020 Accepting new patients
John Cohen, DDS Dental Corp Dentist Past Accepting new patients
Goel & Cohen Dental Corpration Dentist PastSince Aug 1, 2020 Accepting new patients
John Cohen, DDS Dental Corp Dentist Past Accepting new patients
Goel & Cohen Dental Corporation Dentist Past Accepting new patients

Locations

10823 Hawthorne Blvd
Ste A
Inglewood, CA 90304
Phone (310) 412-8013

104 W Anaheim St
Ste C
Wilmington, CA 90744
Phone (310) 830-3452

Organizations & group practices 5

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": "1163116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602547200000",
    "number": "1154492379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10823 HAWTHORNE BLVD STE A",
            "city": "LENNOX",
            "state": "CA",
            "postal_code": "903044322",
            "telephone_number": "818-786-6000",
            "fax_number": "818-786-8820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10823 HAWTHORNE BLVD STE A",
            "city": "LENNOX",
            "state": "CA",
            "postal_code": "903044322",
            "telephone_number": "818-786-6000",
            "fax_number": "818-786-8820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COHEN",
        "first_name": "JOHN",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-10",
        "last_updated": "2020-10-13",
        "certification_date": "2020-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "40423",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "40423",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTICAL PROVIDER NUMBER",
            "identifier": "B40423-01",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lennox, CA

Sources for this page

Verify at the official NPI Registry.