Jerry Cohron, PLLC

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

4043 Issued in KY

Practice address

1048 Ashley St Ste 103a
Bowling Green, KY 42103-2449

Phone

(270) 783-0064

Fax

(270) 901-1997

NPI assigned

Jan 8, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective May 2, 2024 through May 2, 2028

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Dr. Jerry E. Cohron PLLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Bowling Green, KY
  • NPI 1558634808
  NPD (past)

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753747200000",
    "number": "1891843504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1802 ROCKINGHAM AVE",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421043348",
            "telephone_number": "270-783-0064",
            "fax_number": "270-901-1997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1048 ASHLEY ST STE 103A",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421032449",
            "telephone_number": "270-783-0064",
            "fax_number": "270-901-1997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COHRON",
        "first_name": "JERRY",
        "name_prefix": "Dr.",
        "credential": "PLLC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-08",
        "last_updated": "2025-07-29",
        "certification_date": "2025-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0106X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Pathology",
            "state": "KY",
            "license": "4043",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "KY",
            "license": "4043",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64040439",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "60040433",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Oral and Maxillofacial Surgery (Dentist) in Bowling Green, KY
• Providers in Bowling Green, KY by specialty
• Oral and Maxillofacial Surgery (Dentist) in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.