Elena Kogan, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

49427 Issued in CA

Practice address

860 W Redlands Blvd Ste 105
Redlands, CA 92373-8010

Phone

(909) 793-5270

Fax

(909) 793-7679

NPI assigned

Jul 10, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Elena A Kogan Professional name

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Redlands Dental Associates

  • General Practice Dentistry
  • Redlands, CA
  • NPI 1609036706
  NPD (past) Authorized official

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

{
    "created_epoch": "1184025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184025600000",
    "number": "1194923243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "860 W REDLANDS BLVD # 105",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923738010",
            "telephone_number": "909-793-5270",
            "fax_number": "909-793-7679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "860 W REDLANDS BLVD STE 105",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923738010",
            "telephone_number": "909-793-5270",
            "fax_number": "909-793-7679"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOGAN",
        "first_name": "ELENA",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-10",
        "last_updated": "2007-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "49427",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELENA",
            "last_name": "KOGAN",
            "middle_name": "A",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Cassidy Klohr
• Heather Knutson, M.S., CC-A/SLP, FAAA
• Samantha Keiko Kobara, M.S. CCC-SLP
• Ryan Christopher Koca, PHARMD
• Kyle Koch, PA-C
• Ana Claudia Koh, LCSW
• Kokabi Pharmaceutical, Inc.
• Shilo Kolbeck, DPT
• Susan Marie Konkel-White, LMFT
• Byron Timothy Korompis, DPT

• Dentist in Redlands, CA
• Providers in Redlands, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.