Individual provider Active NPI

Michael Cohen, D.D.S.

  • Dentist
  • Ephrata, PA
National Provider Identifier
1588052716
Registry record updated Dec 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
020553-L Issued in PA
Practice address
815 Martin Ave
Ephrata, PA 17522-1642
Phone
(717) 733-7971
NPI assigned
Dec 22, 2014
Last updated
Dec 22, 2014By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 22, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 020553-L PA Primary

Addresses

Primary practice location

815 Martin Ave
Ephrata, PA 17522-1642

Mailing address

815 Martin Ave
Martin Ave
Ephrata, PA 17522-1642
Phone (717) 733-7971

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
020553-LPAMDDentist

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1419206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1419206400000",
    "number": "1588052716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "815 MARTIN AVE",
            "address_2": "MARTIN AVE",
            "city": "EPHRATA",
            "state": "PA",
            "postal_code": "175221642",
            "telephone_number": "717-733-7971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 MARTIN AVE",
            "city": "EPHRATA",
            "state": "PA",
            "postal_code": "175221642",
            "telephone_number": "717-733-7971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COHEN",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-12-22",
        "last_updated": "2014-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PA",
            "license": "020553-L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ephrata, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2014; 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.