Individual provider Active NPI

Marc D Cohen, DDS

  • General Practice Dentistry
  • Encino, CA
National Provider Identifier
1740383249
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
31449 Issued in CA
Practice address
16311 Ventura Boulevard
Suite 1250
Encino, CA 91436
Phone
(818) 789-0555
Fax
(818) 789-5011
NPI assigned
Sep 7, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 31449 CA Primary

Addresses

Primary practice location

16311 Ventura Boulevard
Suite 1250
Encino, CA 91436

Mailing address

16311 Ventura Boulevard
Suite 1250
Encino, CA 91436
Phone (818) 789-0555

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20150716003180 CA Order and Referring Only - DentistPractitioner - Dentist 5799098901

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
31449CAMDRegistered Respiratory Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Marc D. Cohen, D.D.S. and Jana L. Kaye, D.D.S., Dental Corp. General Practice Past Accepting new patients
Saravanan Ram DDS Inc. 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1157587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1740383249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16311 VENTURA BOULEVARD",
            "address_2": "SUITE 1250",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "91436",
            "telephone_number": "818-789-0555",
            "fax_number": "818-789-5011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16311 VENTURA BOULEVARD",
            "address_2": "SUITE 1250",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "91436",
            "telephone_number": "818-789-0555",
            "fax_number": "818-789-5011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COHEN",
        "first_name": "MARC",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "31449",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Encino, CA

Sources for this page

Verify at the official NPI Registry.