Active NPI
Kevin Hewett Cochran, D.M.D.
- General Practice Dentistry
- Wasilla, AK
National Provider Identifier
1831238450
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- AK 883
- Practice address
- 110 E Swanson Ave
Wasilla, AK 99654-7024 - Phone
- (907) 376-5207
- Fax
- (907) 373-3430
- NPI assigned
- Feb 6, 2007
- Last updated
- Jul 8, 2007
- 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | AK 883 | AK | Primary |
Addresses
Primary practice location
110 E Swanson Ave
Wasilla, AK 99654-7024
Mailing address
PO Box 872909
Wasilla, AK 99687-2909
Phone (907) 376-5207
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| DD0883 | Medicaid | AK |
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 |
|---|---|---|---|
| AK 883 | AK | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170720000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1831238450",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 872909",
"city": "WASILLA",
"state": "AK",
"postal_code": "996872909",
"telephone_number": "907-376-5207",
"fax_number": "907-373-3403"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "110 E SWANSON AVE",
"city": "WASILLA",
"state": "AK",
"postal_code": "996547024",
"telephone_number": "907-376-5207",
"fax_number": "907-373-3430"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COCHRAN",
"first_name": "KEVIN",
"middle_name": "HEWETT",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-02-06",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "AK",
"license": "AK 883",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "DD0883",
"state": "AK"
}
],
"endpoints": [],
"other_names": []
}Other providers in Wasilla, AK
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.