Individual provider Active NPI

Paola Cohen Imach, DDS

  • Prosthodontics
  • Tampa, FL
National Provider Identifier
1265637193
Registry record updated Jul 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ProsthodonticsTaxonomy code 1223P0700X
License
DN 21863 Issued in FL
Practice address
2702 W Hillsborough Ave
Tampa, FL 33614-6053
Phone
(813) 365-3021
NPI assigned
Jun 20, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 053091-1 NY
Prosthodontics 1223P0700X DN 21863 FL Primary

Addresses

Primary practice location

2702 W Hillsborough Ave
Tampa, FL 33614-6053

Mailing address

2702 W Hillsborough Ave
Tampa, FL 33614-6053

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20160923001724 FL Order and Referring Only - Other (Physician)Practitioner - Other (Physician) 3678860301

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
053091-1NYMDDentist
DN 21863FLMDProsthodontist

NPI Registry JSON

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

{
    "created_epoch": "1182297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469664000000",
    "number": "1265637193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2702 W HILLSBOROUGH AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336146053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2702 W HILLSBOROUGH AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336146053",
            "telephone_number": "813-365-3021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COHEN IMACH",
        "first_name": "PAOLA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-20",
        "last_updated": "2016-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "053091-1",
            "primary": false
        },
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "FL",
            "license": "DN 21863",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.