Daniel Mark Coen, DDS
Individual provider Active NPI General Practice Dentistry · Creston, IA
NPI 1811044902 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1811044902
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 6118 (IA)
- Practice address
- 110 West Montgomery Street
Creston, IA 50801-2407 - Phone
- (641) 782-8014
- Fax
- (641) 782-8490
- NPI assigned
- Jan 4, 2007
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6118 | IA | MD | General Practice Dentistry |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 6118 | IA | Yes |
Addresses
Primary practice location
110 West Montgomery Street
Creston, IA 50801-2407
Mailing address
110 West Montgomery Street
Creston, IA 50801-2407
Phone (641) 782-8014
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0126664 | Medicaid | IA |
Other providers in Creston, IA
- Makayla Leann Carson
- Sarah Carter
- Ronald William Charles
- Allison L Cheers
- Circle of Life Therapy Services LLC
- Mick Gene Collias
- Kristen D Collier
- Caitlyn Cooper
- Sheena Katherine Cortner
- Jessica Crandall
All providers in Creston, IA · General Practice Dentistry in Iowa
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.