Eric Bernard Kosel, D.M.D.

Primary specialty

DentistTaxonomy code 122300000X

License

019.025881 Issued in IL

Practice address

380 Suppiger Way #3
Highland, IL 62249

Phone

(618) 654-4551

Fax

(708) 532-2917

NPI assigned

Feb 24, 2009

Last updated

May 22, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Cedar Creek Dental Assoc

  • General Practice Dentistry
  • Highland, IL
  • NPI 1275605305
  NPD (past)

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

{
    "created_epoch": "1235433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558483200000",
    "number": "1710127295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "380 SUPPIGER WAY #3",
            "city": "HIGHLAND",
            "state": "IL",
            "postal_code": "62249",
            "telephone_number": "618-654-4551",
            "fax_number": "708-532-2917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "380 SUPPIGER WAY #3",
            "city": "HIGHLAND",
            "state": "IL",
            "postal_code": "62249",
            "telephone_number": "618-654-4551",
            "fax_number": "708-532-2917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOSEL",
        "first_name": "ERIC",
        "middle_name": "BERNARD",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-02-24",
        "last_updated": "2019-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019.025881",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MO",
            "license": "2018009394",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019-025881",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John William Kleinhoffer, OD
• Brian Klostermann, MD
• Erica Sue Kniepkamp
• Mallory Korte, PT
• Renae Joan Korte
• Kevin G. Koth, D.O.
• Rebecca Kroiss, DT
• Allyson Renee Kuelker
• Mark Alan Lacich, DC
• Mary Kirsch Lampe, O.D.

• Dentist in Highland, IL
• Providers in Highland, IL by specialty
• Dentist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2019; 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.

Verify at the official NPI Registry.