Fred D Coffman, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

029142 Issued in CA

Practice address

576 N Sunrise Ave Ste 130
Roseville, CA 95661-2846

Phone

(916) 784-3337

Fax

(916) 784-7459

NPI assigned

Oct 16, 2006

Sex

Male

Sole proprietor

No

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)

Enrolled

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

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1215734400000",
    "number": "1346320116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "576 N SUNRISE AVE STE 130",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956612846",
            "telephone_number": "916-784-3337",
            "fax_number": "916-784-7459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "576 N SUNRISE AVE STE 130",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956612846",
            "telephone_number": "916-784-3337",
            "fax_number": "916-784-7459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COFFMAN",
        "first_name": "FRED",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-16",
        "last_updated": "2008-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "029142",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathleen Agnes Clifton, MS CCC-SLP
• Hannah Clyde
• Jan Coad, PHN/RN
• Meilani Marie Cobb
• Josephine Jennifer Coffey Sandoval, O.D.
• Robert Cogburn, DMD
• Ronald Eugene Cogburn, DDS
• Jessica Coggins
• Ariana Cohen, LM, CPM
• Garrett Steven Cohen, MD

• General Practice Dentistry in Roseville, CA
• Providers in Roseville, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2008; 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.