Individual provider Active NPI

Dennis Neal Cohen, D.M.D

  • Dentist
  • Gardner, MA
National Provider Identifier
1679693113
Registry record updated Aug 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
12373 Issued in MA
Practice address
175 Connors Street
Gardner, MA 01440
Phone
(978) 410-6100
Fax
(978) 410-6176
NPI assigned
Mar 29, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 12373 MA Primary

Addresses

Primary practice location

175 Connors Street
Gardner, MA 01440

Mailing address

326 Nichols Road
Fitchburg, MA 01420
Phone (978) 878-8516

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20161103002170 MA Order and Referring Only - DentistPractitioner - Dentist 9032497516

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12373MAMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439856000000",
    "number": "1679693113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "326 NICHOLS ROAD",
            "city": "FITCHBURG",
            "state": "MA",
            "postal_code": "01420",
            "telephone_number": "978-878-8516",
            "fax_number": "978-878-8418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 CONNORS STREET",
            "city": "GARDNER",
            "state": "MA",
            "postal_code": "01440",
            "telephone_number": "978-410-6100",
            "fax_number": "978-410-6176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COHEN",
        "first_name": "DENNIS",
        "middle_name": "NEAL",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-29",
        "last_updated": "2015-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "12373",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gardner, MA

Sources for this page

Verify at the official NPI Registry.