=====================================================
General NPI Number Information
=====================================================
NPI Number | 1972402139
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | COZZENS DENTAL, PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/04/2026
-----------------------------------------------------
Last Update Date | 11/04/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 712 9TH ST
-----------------------------------------------------
City | PENROSE
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 81240-9553
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 719-372-3041
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 10410 HOLLY SPRINGS PL
-----------------------------------------------------
City | PEYTON
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80831-8209
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 801-941-1358
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DENTIST
-----------------------------------------------------
Name | JOHN ROBERT COZZENS
-----------------------------------------------------
Credential | DMD
-----------------------------------------------------
Telephone | 801-941-1358
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1223G0001X
-----------------------------------------------------
Taxonomy Name | General Practice Dentistry
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------