Individual provider Active NPI

Joseph Samuel Cohen

  • General Practice Dentistry
  • Collingswood, NJ
National Provider Identifier
1619065372
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
12583 Issued in NJ
Practice address
831 Haddon Ave
Collingswood, NJ 08108
Phone
(856) 833-9174
Fax
(856) 854-0758
NPI assigned
Oct 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 12583 NJ Primary

Addresses

Primary practice location

831 Haddon Ave
Collingswood, NJ 08108

Mailing address

831 Haddon Ave
Collingswood, NJ 08108
Phone (856) 833-9174

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151104000780 NJ Order and Referring Only - DentistPractitioner - Dentist 8022328079

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12583NJMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1619065372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "831 HADDON AVE",
            "city": "COLLINGSWOOD",
            "state": "NJ",
            "postal_code": "08108",
            "telephone_number": "856-833-9174",
            "fax_number": "856-854-0758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "831 HADDON AVE",
            "city": "COLLINGSWOOD",
            "state": "NJ",
            "postal_code": "08108",
            "telephone_number": "856-833-9174",
            "fax_number": "856-854-0758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COHEN",
        "first_name": "JOSEPH",
        "middle_name": "SAMUEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "12583",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Collingswood, NJ

Sources for this page

Verify at the official NPI Registry.