Paul L Coren, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

08265 Issued in MD

Practice address

577 Sternberg Ave
Headquarters US Army Dental Activity Credentials Office
Fort Eustis, VA 23604-5311

Phone

(757) 314-7944

Fax

(757) 314-7942

NPI assigned

Sep 29, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189468800000",
    "number": "1255423901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "577 STERNBERG AVE",
            "address_2": "HEADQUARTERS US ARMY DENTAL ACTIVITY CREDENTIALS OFFICE",
            "city": "FORT EUSTIS",
            "state": "VA",
            "postal_code": "236045311",
            "telephone_number": "757-314-7944",
            "fax_number": "757-314-7942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "577 STERNBERG AVE",
            "address_2": "HEADQUARTERS US ARMY DENTAL ACTIVITY CREDENTIALS OFFICE",
            "city": "FORT EUSTIS",
            "state": "VA",
            "postal_code": "236045311",
            "telephone_number": "757-314-7944",
            "fax_number": "757-314-7942"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COREN",
        "first_name": "PAUL",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-29",
        "last_updated": "2007-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MD",
            "license": "08265",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephany Anne Cockrum
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• Robin Theresa Collard, O.D.
• Everdean T Collins, RN
• Margaret A Costello Shea, R.N.
• Natasha M Crichlow
• Brad Cunningham, OD
• David De Sena, DO
• Jonathan Decker, PHARMD

• All providers in Fort Eustis, VA
• Dentist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.