Individual provider Active NPI

Jacob Nathaniel Cole, DMD

  • Student in an Organized Health Care Education/Training Program
  • Pittsburgh, PA
National Provider Identifier
1396431441
Registry record updated Jun 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
DS044120 Issued in PA
Practice address
3501 Terrace St G-32 Salk Hall
Pittsburgh, PA 15261-2582
Phone
(412) 648-8616
NPI assigned
Apr 12, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Student in an Organized Health Care Education/Training Program 390200000X DS044120 PA Primary

Addresses

Primary practice location

3501 Terrace St G-32 Salk Hall
Pittsburgh, PA 15261-2582

Mailing address

3600 Forbes Ave Ste 140
Pittsburgh, PA 15213-3410
Phone (412) 647-5815

Other practice location 1

200 Lothrop St
Pittsburgh, PA 15213-2582
Phone (412) 647-2345

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20230712000248 PA Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 7315307105

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DS044120PAMDStudent in an Organized Health Care Education/Training Program

NPI Registry JSON

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

{
    "created_epoch": "1681257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686441600000",
    "number": "1396431441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 FORBES AVE STE 140",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152133410",
            "telephone_number": "412-647-5815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3501 TERRACE ST G-32 SALK HALL",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152612582",
            "telephone_number": "412-648-8616"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Lothrop St",
            "address_purpose": "LOCATION",
            "city": "Pittsburgh",
            "state": "PA",
            "postal_code": "152132582",
            "country_code": "US",
            "telephone_number": "412-647-2345",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COLE",
        "first_name": "JACOB",
        "middle_name": "NATHANIEL",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-04-12",
        "last_updated": "2023-06-11",
        "certification_date": "2023-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "PA",
            "license": "DS044120",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pittsburgh, PA

Sources for this page

Verify at the official NPI Registry.