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1295955920 NPI number — MARK KOGAN DMD

NPI Number: 1295955920
Health Care Provider/Practitioner: MARK KOGAN DMD

Information about “1295955920” NPI (MARK KOGAN DMD) exists in 1295955920 in HTML format HTML  |  1295955920 in plain Text format TXT  |  1295955920 in PDF (Portable Document Format) PDF  |  1295955920 in an XML format XML  formats.

NPI Number : 1295955920 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1295955920",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "KOGAN",
    "FirstName": "MARK",
    "MiddleName": null,
    "NamePrefix": "DR.",
    "NameSuffix": null,
    "Credential": "DMD",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "30 E 40TH ST",
    "SecondLineMailingAddress": "SUITE 207",
    "MailingAddressCityName": "NEW YORK",
    "MailingAddressStateName": "NY",
    "MailingAddressPostalCode": "10016-1201",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "212-696-4979",
    "MailingAddressFaxNumber": "212-447-5786",
    "FirstLinePracticeLocationAddress": "30 E 40TH ST",
    "SecondLinePracticeLocationAddress": "SUITE 207",
    "PracticeLocationAddressCityName": "NEW YORK",
    "PracticeLocationAddressStateName": "NY",
    "PracticeLocationAddressPostalCode": "10016-1201",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "212-696-4979",
    "PracticeLocationAddressFaxNumber": "212-447-5786",
    "EnumerationDate": "04/26/2007",
    "LastUpdateDate": "07/09/2007",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "122300000X",
        "TaxonomyName": "Dentist",
        "LicenseNumber": "051647-1",
        "LicenseNumberStateCode": "NY",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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