Active NPI
Justin Cohen, D.M.D.
- Endodontics
- New York, NY
National Provider Identifier
1669696316
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endodontics
- License
- 0417141
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20151019001164 | NY | Order and Referring Only - Oral Surgery | 8628387446 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0417141 | NY | MD | Endodontist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Suite 2229 Dental PLLC | Past | 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.
-
- Oral and Maxillofacial Surgery (Dentist)
- New York, NY
- NPI 1619765377
-
- Dentist
- Commack, NY
- NPI 1922640911
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.