Active NPI
Jake Kosman, DMD
- General Practice Dentistry
- Amherst, OH
National Provider Identifier
1295698546
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 30.028196
- Practice address
- 401 N Leavitt Rd
Amherst, OH 44001-1128 - Phone
- (440) 988-4166
- NPI assigned
- Dec 4, 2025
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 30.028196 | OH | Primary |
Addresses
Primary practice location
401 N Leavitt Rd
Amherst, OH 44001-1128
Mailing address
4791 E Lake Rd
Sheffield Lake, OH 44054-1436
Phone (440) 864-7924
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 30.028196 | OH | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1764806400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1764806400000",
"number": "1295698546",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4791 E LAKE RD",
"city": "SHEFFIELD LAKE",
"state": "OH",
"postal_code": "440541436",
"telephone_number": "440-864-7924"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "401 N LEAVITT RD",
"city": "AMHERST",
"state": "OH",
"postal_code": "440011128",
"telephone_number": "440-988-4166"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOSMAN",
"first_name": "JAKE",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2025-12-04",
"last_updated": "2025-12-04",
"certification_date": "2025-12-04",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dentist, General Practice",
"state": "OH",
"license": "30.028196",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Amherst, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.