Robert Cogburn, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

62973 Issued in CA

Practice address

1950 Douglas Blvd
Ste B1
Roseville, CA 95661-3825

Phone

(916) 783-7105

NPI assigned

Mar 6, 2014

Last updated

Mar 6, 2014By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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.

• KHS Pannu DDS Inc

  • Dental Clinic/Center
  • Roseville, CA
  • NPI 1457875809
  NPD (past)

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

{
    "created_epoch": "1394064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1394064000000",
    "number": "1710303300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 DOUGLAS BLVD",
            "address_2": "STE B1",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956613825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1950 DOUGLAS BLVD",
            "address_2": "STE B1",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956613825",
            "telephone_number": "916-783-7105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COGBURN",
        "first_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-03-06",
        "last_updated": "2014-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "62973",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hannah Clyde
• Jan Coad, PHN/RN
• Meilani Marie Cobb
• Josephine Jennifer Coffey Sandoval, O.D.
• Fred D Coffman, DDS
• Ronald Eugene Cogburn, DDS
• Jessica Coggins
• Ariana Cohen, LM, CPM
• Garrett Steven Cohen, MD
• Michael W Cohen, MD

• Dentist in Roseville, CA
• Providers in Roseville, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2014; 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.