Individual provider Active NPI

Robert J Kogen, DDS

  • General Practice Dentistry
  • Newhall, CA
National Provider Identifier
1912019233
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
25924 Issued in CA
Practice address
22817 Lyons Ave
Newhall, CA 91321-2819
Phone
(661) 259-2311
NPI assigned
Aug 31, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 25924 CA Primary

Addresses

Primary practice location

22817 Lyons Ave
Newhall, CA 91321-2819

Mailing address

22817 Lyons Ave
Newhall, CA 91321-2819
Phone (661) 259-2311

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20151207001264 CA Order and Referring Only - DentistPractitioner - Dentist 8426358920

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1912019233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22817 LYONS AVE",
            "city": "NEWHALL",
            "state": "CA",
            "postal_code": "913212819",
            "telephone_number": "661-259-2311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22817 LYONS AVE",
            "city": "NEWHALL",
            "state": "CA",
            "postal_code": "913212819",
            "telephone_number": "661-259-2311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOGEN",
        "first_name": "ROBERT",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "25924",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newhall, CA

Sources for this page

Verify at the official NPI Registry.