Individual provider Active NPI

Robert Mark Cohen, DDS

  • Periodontics
  • Los Angeles, CA
National Provider Identifier
1235292095
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
33424 Issued in CA
Practice address
3932 Wilshire Blvd
#100
Los Angeles, CA 90010
Phone
(213) 386-3336
Fax
(213) 386-2985
NPI assigned
Dec 19, 2006
Last updated
Jul 8, 2007By the provider in NPPES
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
Periodontics 1223P0300X 33424 CA Primary

Addresses

Primary practice location

3932 Wilshire Blvd
#100
Los Angeles, CA 90010

Mailing address

1358 Holmby Avenue
Los Angeles, CA 90024-5112
Phone (310) 474-6372

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
I20150902000322 CA Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 4385950617

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
33424CAMDPeriodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Kaplan Dental Corporation PastSince Sep 17, 2023 Accepting new patients
Gregory D. Kaplan,DDS Periodontics Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1235292095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1358 HOLMBY AVENUE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900245112",
            "telephone_number": "310-474-6372",
            "fax_number": "310-474-7152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3932 WILSHIRE BLVD",
            "address_2": "#100",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90010",
            "telephone_number": "213-386-3336",
            "fax_number": "213-386-2985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COHEN",
        "first_name": "ROBERT",
        "middle_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "CA",
            "license": "33424",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.