MEDICARE: DR. JAMES A COGLIANESE DDS MS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist		IL
2	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry		IL

General Provider Information

NPI Number	:	1528196599
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES A COGLIANESE DDS MS

Provider Business Mailing Address
First Line	:	7350 WEST COLLEGE DRIVE
Second Line	:
City	:	PALOS HEIGHTS
State	:	IL
Zip	:	60463-1149
Country	:	US
Telephone Number	:	708-448-8400
Fax Number	:

Provider Business Practice Location Address
First Line	:	7350 WEST COLLEGE DRIVE
Second Line	:
City	:	PALOS HEIGHTS
State	:	IL
Zip	:	60463-1149
Country	:	US
Telephone Number	:	708-448-8400
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/01/2007
Last Update Date	:	09/11/2025

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