L. Todd Cochran, DDS

Individual provider Active NPI General Practice Dentistry · Alta Loma, CA

NPI 1457555476 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1457555476
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
28850 (CA)
Practice address
7283 Carnelian St
Alta Loma, CA 91701-5526
Phone
(909) 987-6268
Fax
(909) 477-4509
NPI assigned
Jun 13, 2007
Sex
Male
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
28850CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Ha Jung Kim Dental Corp Past
since Oct 15, 2023
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 28850 CA Yes

Addresses

Primary practice location

7283 Carnelian St
Alta Loma, CA 91701-5526

Mailing address

7283 Carnelian St
Alta Loma, CA 91701-5526
Phone (909) 987-6268

Other providers in Alta Loma, CA

All providers in Alta Loma, CA · General Practice Dentistry in California

Sources for this page

Verify at the official NPI Registry.