Omar T Cockey is a Dentist in Waukegan, Illinois. Omar T Cockey practices all healthcare services and medical treatments related to Dentist. The NPI Number for Omar T Cockey is 1154446318. The last update date is 2013-12-04.
Omar T Cockey's current location address is 3010 Grand Ave, Waukegan, Illinois. You can contact this provider via phone number 8473778604. The mailing address for Omar T Cockey is 3010 Grand Ave, Waukegan, Illinois. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Omar T Cockey |
|---|---|
| Address | 3010 Grand Ave, Waukegan, Illinois |
| Phone Number | 8473778604 |
| Fax Number | |
| Sole Proprietor | Y |
| Credentials | DMD,MPH |
NPI Number Detail
| NPI Number | 1154446318 |
|---|---|
| Provider Enumeration Date | 2007-03-20 |
| Last Updated Date | 2013-12-04 |
Provider Mailing Address Detail
| Address | 3010 Grand Ave |
|---|---|
| City | Waukegan |
| State | Illinois (IL) |
| Post Code | 600852321 |
| Phone Number | 8473778604 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Dentist |
|---|---|
| Taxonomy | 122300000X |
| Licence No | DI 17684 |
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Definition: A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: denti |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 4608909 | NJ | -- |
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What is the unique 10-digit identifier code assigned to Omar T Cockey by the Centers for Medicare & Medicaid Services?
The Omar T Cockey has been issued the NPI (National Provider Identifier) 1154446318 by the CMS (Centers for Medicare & Medicaid Services), which serves as a unique identification number for healthcare providers.
Could you please provide the complete physical location address of Omar T Cockey?
The Omar T Cockey is physically situated at 3010 Grand Ave, in the city of Waukegan, state of IL, with the postal code 600852321.
What is Omar T Cockey's specialized field of practice, and what is the corresponding taxonomy classification code?
The Omar T Cockey's area of specialization is Dentist, and the corresponding taxonomy code that categorizes this field of practice is 122300000X.
On what date did the Centers for Medicare & Medicaid Services assign the 1154446318 to Omar T Cockey?
The Centers for Medicare & Medicaid Services assigned the 1154446318 to Omar T Cockey on 2007-03-20.
When was the information related to Omar T Cockey most recently updated or refreshed?
The details pertaining to the Omar T Cockey, including its address, specialty, and other relevant information, were last updated or refreshed on 2013-12-04.