Individual provider Active NPI

David L Cochran, DDS MS PHD MMSCI

  • Periodontics
  • San Antonio, TX
National Provider Identifier
1871675967
Registry record updated Nov 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
17468 Issued in TX
Practice address
7703 Floyd Curl Dr
Dept of Periodontics
San Antonio, TX 78229
Phone
(210) 567-6405
Fax
(210) 567-2844
NPI assigned
Oct 19, 2006
Last updated
Nov 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 17468 TX
Periodontics 1223P0300X 17468 TX Primary

Addresses

Primary practice location

7703 Floyd Curl Dr
Dept of Periodontics
San Antonio, TX 78229

Mailing address

PO Box 40397
San Antonio, TX 78229-3900
Phone (210) 567-6405

Other identifiers 3

IdentifierTypeStateIssuer
090665302MedicaidTX
837630OtherBLUE CROSS BLUE SHIELD
090665301MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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

Enrollment IDStateProvider typePAC IDDetails
I20110606000741 TX Practitioner - Oral Surgery 2961689658 Practice locations: San Antonio, TX

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science, Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
17468TXMDDentist

Interoperability endpoints

  • Direct secure messaging: dcochran60949@direct.utmsa.com

NPI Registry JSON

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668988800000",
    "number": "1871675967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 40397",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293900",
            "telephone_number": "210-567-6405",
            "fax_number": "210-567-2844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7703 FLOYD CURL DR",
            "address_2": "DEPT OF PERIODONTICS",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "78229",
            "telephone_number": "210-567-6405",
            "fax_number": "210-567-2844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COCHRAN",
        "first_name": "DAVID",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "DDS MS PHD MMSCI",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-19",
        "last_updated": "2022-11-21",
        "certification_date": "2022-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "17468",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "TX",
            "license": "17468",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "090665302",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "837630",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "090665301",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.