Douglas J Kosek DDS PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

12009873 Issued in IN

Legal business name

DOUGLAS J KOSEK DDS PC

Practice address

413 West Jefferson Blvd
South Bend, IN 46601-1514

Phone

(574) 232-2992

Fax

(574) 232-2739

NPI assigned

Nov 29, 2006

Organization subpart

No

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

Authorized official

Name

Douglas John Kosek, DDSNPI 1780704247

Title

President

Phone

(574) 232-2992

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Douglas John Kosek, D.D.S.

  • General Practice Dentistry
  • South Bend, IN
  • NPI 1780704247
  NPD (past) Authorized official

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

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1811064215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "413 WEST JEFFERSON BLVD",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466011514",
            "telephone_number": "574-232-2992",
            "fax_number": "574-232-2739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "413 WEST JEFFERSON BLVD",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466011514",
            "telephone_number": "574-232-2992",
            "fax_number": "574-232-2739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOUGLAS J KOSEK DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-29",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KOSEK",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "574-232-2992",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12009873",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Willie Lee Donald, M.D.
• Mary K Donigan, AUD
• Rita Donley, PH.D.
• Amanda Keri Dorman, MA, BCBA
• Douglas J Kosek D.D.S., P.C.
• David Wood Douglas, D.D.S.
• James Alvin Douglas, D.D.S.
• Kevin Matthew Downey, DDS
• Jacob Andrew Downs
• Allison Elizabeth Doyle, APNP

• General Practice Dentistry in South Bend, IN
• Providers in South Bend, IN by specialty
• General Practice Dentistry in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.