Coghlan Orthodontics

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

12008895A Issued in IN

Legal business name

COGHLAN ORTHODONTICS

Practice address

2911 E Covenanter Dr
Bloomington, IN 47401-6320

Phone

(812) 332-9269

Fax

(812) 335-9052

NPI assigned

Mar 20, 2007

Organization subpart

No

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

Authorized official

Name

Paula Dyer

Title

Practice Administrator

Phone

(812) 332-9269

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• John Kevin Coghlan, D.D.S, M.S.D.

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Bloomington, IN
  • NPI 1093740433
  NPD (past)

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1518082643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2911 E COVENANTER DR",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474016320",
            "telephone_number": "812-332-9269",
            "fax_number": "812-335-9052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2911 E COVENANTER DR",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474016320",
            "telephone_number": "812-332-9269",
            "fax_number": "812-335-9052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COGHLAN ORTHODONTICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DYER",
        "authorized_official_first_name": "PAULA",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "812-332-9269"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "IN",
            "license": "12008895A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Catie Cobble, RBT
• Michael Coburn
• Nicolas Arun Cochran, BA, RBT
• Emily Coffman, RBT
• Zoe Coffman
• Elaine Coghlan, DDS
• John Kevin Coghlan, D.D.S, M.S.D.
• Deborah Cohen, LCSW
• Rebecca J Cohen, M.D.
• Lindita N Coku, M.D.

• Orthodontics and Dentofacial Orthopedics Dentistry in Bloomington, IN
• Providers in Bloomington, IN by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.