ETHAN COOK DDS
NPI 1679357990
Dentist - General Practice in Santa Rosa, CA

Q: What is Ethan Cook's NPI number?

The NPI number for Ethan Cook is 1679357990. It was assigned to this individual provider in the NPPES registry on August 21, 2023.

Q: What is Ethan Cook's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Q: When was this NPI record last updated?

The NPPES record for Ethan Cook was last updated on August 21, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since August 21, 2023PECOS Enrolled

2448 GUERNEVILLE RD STE 200, SANTA ROSA, CA 95403(707) 579-2808 Get Directions Write a Review

NPPES record last updated: August 21, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

On this page

About Ethan Cook Dds NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ETHAN COOK DDS (NPI 1679357990) is an individual general practice provider in Santa Rosa, California, licensed in California (108995) and active in the NPI registry since August 2023. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1679357990

Entity TypeIndividualMale

Primary Taxonomy1223G0001X

Provider Legal NameETHAN COOKCredential: DDS

Location Address2448 GUERNEVILLE RD STE 200Santa Rosa, CA 95403-7223

Mailing Address2448 Guerneville Rd Ste 200Santa Rosa, CA 95403-7223 · (707) 579-2808

Phone(707) 579-2808

Sole ProprietorYes

Enumeration DateAugust 21, 2023

NPPES CertifiedAugust 20, 2023

✔ NPI 1679357990 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers

Taxonomy Code1223G0001X

License✔ Licensed in CA · 108995

Definition

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

2448 GUERNEVILLE RD STE 200, Santa Rosa, CA 95403

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, BEST Life, Florida Combined Life and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Ethan Cook Dds is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 95403 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$96.16 typical visit price

range $63.04 – $187.01

Typical copayment $24.04 (range $15.76 – $46.75)

Most-billed visit code 99203

Established Patient

$77.94 typical visit price

range $21.02 – $153.40

Typical copayment $19.48 (range $5.25 – $38.35)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. ANKITA KAKAR DDS

Dentist

2448 GUERNEVILLE RD STE 200
SANTA ROSA, CA 95403

Sonoma County (707) 579-2808

PETERSEN DENTAL CARE

Clinic/Center (Dental)

2448 GUERNEVILLE RD STE 200
SANTA ROSA, CA 95403

Sonoma County (707) 579-2808

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Ethan Cook's NPI number?

The NPI number for Ethan Cook is 1679357990. It was assigned to this individual provider in the NPPES registry on August 21, 2023.

Where is Ethan Cook located?

Ethan Cook practices at 2448 Guerneville Rd Ste 200, Santa Rosa, CA 95403. The listed phone number is (707) 579-2808.

What is Ethan Cook's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Is Ethan Cook enrolled in Medicare?

Yes. Ethan Cook is registered in the Medicare PECOS enrollment system.

What insurance does Ethan Cook accept?

Health plans from Anthem Blue Cross and Blue Shield, BEST Life, Florida Combined Life, Humana and Renaissance Dental and 1 other insurer list Ethan Cook as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Ethan Cook was last updated on August 21, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.