Individual provider Active NPI

Nathaniel Tyler Cogswell, DDS

  • General Practice Dentistry
  • Saint Paul, MN
National Provider Identifier
1225415896
Registry record updated Aug 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D13398 Issued in MN
Practice address
2278 Como Ave
Saint Paul, MN 55108-1794
Phone
(651) 400-8966
NPI assigned
May 2, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2024

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 D13398 MN Primary

Addresses

Primary practice location

2278 Como Ave
Saint Paul, MN 55108-1794

Mailing address

2278 Como Ave
Saint Paul, MN 55108-1794
Phone (651) 400-8966

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20150923003107 MN Order and Referring Only - DentistPractitioner - Dentist 4183931157

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Hibernation Sleep MN LLC General Practice CurrentSince May 2, 2018 Accepting new patients
Saint Anthony Park Dental Care PLLC General Practice Past Accepting new patients

Locations

2278 Como Ave
Saint Paul, MN 55108
Phone (651) 644-3685

Organizations & group practices 2

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": "1430524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723593600000",
    "number": "1225415896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2278 COMO AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551081794",
            "telephone_number": "651-400-8966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2278 COMO AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551081794",
            "telephone_number": "651-400-8966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COGSWELL",
        "first_name": "NATHANIEL",
        "middle_name": "TYLER",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-05-02",
        "last_updated": "2024-08-14",
        "certification_date": "2024-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D13398",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.