David Brian Coates, D.D.S.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

12008777 Issued in IN

Practice address

2204 Scott St
Lafayette, IN 47904-2933

Phone

(765) 447-0525

Fax

(765) 447-5815

NPI assigned

Jun 2, 2005

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jun 16, 2023 through Jun 16, 2027

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1117670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285632000000",
    "number": "1568464527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2204 SCOTT ST",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479042933",
            "telephone_number": "765-447-0525",
            "fax_number": "765-447-5815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2204 SCOTT ST",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479042933",
            "telephone_number": "765-447-0525",
            "fax_number": "765-447-5815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COATES",
        "first_name": "DAVID",
        "middle_name": "BRIAN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-02",
        "last_updated": "2010-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "IN",
            "license": "12008777",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100445200A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Charles T Cline, MD
• Emily Cline
• Josh Cline
• Nadine L Cline, N.P.
• Glenda Clossin
• David E Cobb, PT
• Dorothy Cobb, MS CCC-SLP
• Christopher David Cobbs, M.D.
• Monette Carole Cochran, RN
• Heather Coe, CRNA

• Oral and Maxillofacial Surgery (Dentist) in Lafayette, IN
• Providers in Lafayette, IN by specialty
• Oral and Maxillofacial Surgery (Dentist) in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.