Active NPI
Raul Cook, DDS,MS
- Periodontics
- Fort Lauderdale, FL
National Provider Identifier
1720241797
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- DN18465
- Practice address
- 2480 E Commercial Blvd
Penthouse 1
Fort Lauderdale, FL 33308-4025 - Phone
- (954) 771-9090
- NPI assigned
- Jul 9, 2008
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Periodontics | 1223P0300X | DN18465 | FL | Primary |
Addresses
Primary practice location
2480 E Commercial Blvd
Penthouse 1
Fort Lauderdale, FL 33308-4025
Mailing address
2480 E Commercial Blvd
Penthouse 1
Fort Lauderdale, FL 33308-4025
Phone (954) 771-9090
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- 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 |
|---|---|---|---|---|
| I20160420001376 | FL | Order and Referring Only - Other (Physician) | 6305144601 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1215561600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1324944000000",
"number": "1720241797",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2480 E COMMERCIAL BLVD",
"address_2": "PENTHOUSE 1",
"city": "FORT LAUDERDALE",
"state": "FL",
"postal_code": "333084025",
"telephone_number": "954-771-9090"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2480 E COMMERCIAL BLVD",
"address_2": "PENTHOUSE 1",
"city": "FORT LAUDERDALE",
"state": "FL",
"postal_code": "333084025",
"telephone_number": "954-771-9090"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COOK",
"first_name": "RAUL",
"name_prefix": "Dr.",
"credential": "DDS,MS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-07-09",
"last_updated": "2011-12-27",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "FL",
"license": "DN18465",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Lauderdale, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2011; 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.