Individual provider Active NPI

Martin K Coonen, DDS

  • Dentist
  • Helena, MT
National Provider Identifier
1922263086
Registry record updated Mar 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2313 Issued in MT
Practice address
64 Medical Park Dr Ste 1
Helena, MT 59601-4903
Phone
(406) 442-3190
Fax
(406) 449-9957
NPI assigned
Jul 28, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health Dentistry 1223D0001X 2313 MT
Dentist 122300000X 2313 MT Primary

Addresses

Primary practice location

64 Medical Park Dr Ste 1
Helena, MT 59601-4903

Mailing address

64 Medical Park Dr Ste 1
Helena, MT 59601-4903
Phone (406) 442-3191

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT
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
I20151112001872 MT Order and Referring Only - DentistPractitioner - Dentist 8921318486

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2313MTMDPublic Health Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Martin K. Coonen, DDS PC Dentist Current Accepting new patients

Locations

64 Medical Park Dr
Ste 1
Helena, MT 59601
Phone (406) 442-3190

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1217203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362528000000",
    "number": "1922263086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "64 MEDICAL PARK DR STE 1",
            "city": "HELENA",
            "state": "MT",
            "postal_code": "596014903",
            "telephone_number": "406-442-3191",
            "fax_number": "406-449-9957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "64 MEDICAL PARK DR STE 1",
            "city": "HELENA",
            "state": "MT",
            "postal_code": "596014903",
            "telephone_number": "406-442-3190",
            "fax_number": "406-449-9957"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COONEN",
        "first_name": "MARTIN",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-28",
        "last_updated": "2013-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223D0001X",
            "taxonomy_group": "",
            "desc": "Dentist, Dental Public Health",
            "state": "MT",
            "license": "2313",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MT",
            "license": "2313",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Helena, MT

Sources for this page

Verify at the official NPI Registry.