Samuel Coste

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D11645 Issued in OR

Practice address

2530 NW Medical Park Dr
Roseburg, OR 97471-5510

Phone

(541) 837-1713

NPI assigned

Oct 31, 2022

Last updated

Oct 31, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Enrolled in OR

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.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1667174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667174400000",
    "number": "1851008791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "442 SW UMATILLA AVE STE 200",
            "city": "REDMOND",
            "state": "OR",
            "postal_code": "977567039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2530 NW MEDICAL PARK DR",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974715510",
            "telephone_number": "541-837-1713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COSTE",
        "first_name": "SAMUEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-10-31",
        "last_updated": "2022-10-31",
        "certification_date": "2022-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D11645",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Maggie Cote, DMD
• Jena M Cottrell, FNP
• Justin David Counts, CSWA
• Theodore Counts
• County of Douglas (Douglas County Mental Health)

• General Practice Dentistry in Roseburg, OR
• Providers in Roseburg, OR by specialty
• General Practice Dentistry in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.