Provider Demographics
NPI:1518160977
Name:COST, JOEL M (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOEL
Middle Name:M
Last Name:COST
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:650 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:OH
Mailing Address - Zip Code:45619-1039
Mailing Address - Country:US
Mailing Address - Phone:740-867-3161
Mailing Address - Fax:740-867-8561
Practice Address - Street 1:650 3RD AVE
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:OH
Practice Address - Zip Code:45619-1039
Practice Address - Country:US
Practice Address - Phone:740-867-3161
Practice Address - Fax:740-867-8561
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH225221223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice