Jack H Corn, D.M.D

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN9100 Issued in FL

Practice address

80 S Tuttle Ave
Sarasota, FL 34237-6331

Phone

(941) 924-4210

Fax

(941) 927-0563

NPI assigned

Nov 11, 2006

Last updated

Jul 8, 2007By 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

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Apr 4, 2016 through Apr 4, 2028

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1163203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1770654899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1529 OAK WAY",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342323452",
            "telephone_number": "941-377-4208",
            "fax_number": "941-371-5158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 S TUTTLE AVE",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342376331",
            "telephone_number": "941-924-4210",
            "fax_number": "941-927-0563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORN",
        "first_name": "JACK",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN9100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christine Lynn Corcoran, MS, RMHI
• Jose Gabriel Cordero Castaneda
• Martina Cordero
• Nitza Cordero
• Alfredo Cesar Cordova, M.D.
• Lydia Gay Corn, M.D.
• Alvaro Cornejo Cobo, M.D.
• Cornerstone Caregiving East LLC
• Cornerstone Healthcare Clinic
• Nancy Ann Cornett, PA-C

• General Practice Dentistry in Sarasota, FL
• Providers in Sarasota, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.