Individual provider Active NPI

Justin Cohen, D.M.D.

  • Endodontics
  • New York, NY
National Provider Identifier
1669696316
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
0417141 Issued in NY
Practice address
150 Broadway
Suite 1310
New York, NY 10038-4381
Phone
(212) 587-0202
NPI assigned
Apr 12, 2007
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
Endodontics 1223E0200X 0417141 NY Primary

Addresses

Primary practice location

150 Broadway
Suite 1310
New York, NY 10038-4381

Mailing address

3 White Dr
Cedarhurst, NY 11516-2607
Phone (516) 569-6340

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20151019001164 NY Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 8628387446

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0417141NYMDEndodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Suite 2229 Dental PLLC PastSince Oct 1, 2019 Accepting new patients
Dental Group of Manhattan PLLC Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1176336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1669696316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 WHITE DR",
            "city": "CEDARHURST",
            "state": "NY",
            "postal_code": "115162607",
            "telephone_number": "516-569-6340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 BROADWAY",
            "address_2": "SUITE 1310",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100384381",
            "telephone_number": "212-587-0202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COHEN",
        "first_name": "JUSTIN",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "NY",
            "license": "0417141",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.