Rebecca L Cook, DMD

Individual provider Active NPI Dentist · Whitesburg, KY

NPI 1497075188 · NPPES record last updated Jan 6, 2012

Key facts

NPI
1497075188
Entity type
Individual (NPI type 1)
Primary specialty
Dentist 122300000X
License
8896 (KY)
Practice address
226 Medical Plaza LN
Whitesburg, KY 41858-7425
Phone
(606) 633-4871
Fax
(606) 633-1874
NPI assigned
Jun 4, 2010
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20151103002431 KY Order and Referring Only - Dentist
Practitioner - Dentist
1557671567

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
8896KYMDDentist

Interoperability endpoints

  • Direct secure messaging: rebecca.cook.p1@direct.mtncomp.nextgenshare.com

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 8896 KY Yes

Addresses

Primary practice location

226 Medical Plaza LN
Whitesburg, KY 41858-7425

Mailing address

PO Box 40
Whitesburg, KY 41858-0040
Phone (606) 633-4823

Other identifiers

IdentifierTypeStateIssuer
7100122040MedicaidKY

Other names

  • Rebecca L Roberts Former name

Other providers in Whitesburg, KY

All providers in Whitesburg, KY · Dentist in Kentucky

Sources for this page

Verify at the official NPI Registry.