Active NPI
Jonathan King Cole, D.M.D.
- Periodontics
- Du Bois, PA
National Provider Identifier
1811001647
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- DS024511L
- Practice address
- 190 W Park Ave Ste 4
Du Bois, PA 15801-2277 - Phone
- (814) 375-7515
- Fax
- (814) 375-1270
- NPI assigned
- Aug 18, 2006
- 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 | DS024511L | PA | Primary |
Addresses
Primary practice location
190 W Park Ave Ste 4
Du Bois, PA 15801-2277
Mailing address
318 Hillcrest Dr
Du Bois, PA 15801-2342
Phone (814) 375-8990
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 112780 | Other | PA | INSURANCE PROVIDER ID |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DS024511L | PA | MD | Periodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155859200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1811001647",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "318 HILLCREST DR",
"city": "DU BOIS",
"state": "PA",
"postal_code": "158012342",
"telephone_number": "814-375-8990",
"fax_number": "814-371-0290"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "190 W PARK AVE STE 4",
"city": "DU BOIS",
"state": "PA",
"postal_code": "158012277",
"telephone_number": "814-375-7515",
"fax_number": "814-375-1270"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COLE",
"first_name": "JONATHAN",
"middle_name": "KING",
"credential": "D.M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-18",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "PA",
"license": "DS024511L",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "INSURANCE PROVIDER ID",
"identifier": "112780",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Du Bois, PA
Sources for this page
- 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.