Individual provider Active NPI

Larry Jay Cohen, DDS

  • Dentist
  • Bethpage, NY
National Provider Identifier
1245204726
Registry record updated Feb 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
0407011 Issued in NY
Practice address
190 Hicksville Rd
Bethpage, NY 11714-3409
Phone
(516) 735-0525
Fax
(516) 735-0143
NPI assigned
Feb 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 0407011 NY Primary

Addresses

Primary practice location

190 Hicksville Rd
Bethpage, NY 11714-3409

Mailing address

190 Hicksville Rd
Bethpage, NY 11714-3409
Phone (516) 735-0525

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20150624001833 NY Order and Referring Only - DentistPractitioner - Dentist 6507177045

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0407011NYMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Larry Cohen DDS PC Past Accepting new patients

Organizations & group practices 1

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": "1139875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423699200000",
    "number": "1245204726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 HICKSVILLE RD",
            "city": "BETHPAGE",
            "state": "NY",
            "postal_code": "117143409",
            "telephone_number": "516-735-0525",
            "fax_number": "516-735-0143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "190 HICKSVILLE RD",
            "city": "BETHPAGE",
            "state": "NY",
            "postal_code": "117143409",
            "telephone_number": "516-735-0525",
            "fax_number": "516-735-0143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COHEN",
        "first_name": "LARRY",
        "middle_name": "JAY",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-14",
        "last_updated": "2015-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "0407011",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethpage, NY

Sources for this page

Verify at the official NPI Registry.