Ethan Cook, DDS
NPI 1679357990ActiveIndividual· Dentist, General Practice· Santa Rosa, CA
Dentist, General Practice (DDS) in Santa Rosa, California, licensed in CA, with an NPI issued in August 2023. Enrolled in Medicare as order and referring only - dentist.
Overview
| NPI | 1679357990 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | DDS |
| Sole proprietor | Yes |
| NPI issued | Aug 21, 2023 |
| Last updated in NPPES | Aug 21, 2023 |
| Certified by provider | Aug 20, 2023 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dentist, General Practice Primary | 1223G0001X | 108995 | CA |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Order and Referring Only - Dentist (CA) |
|---|
Industry payments (Open Payments)
None reported for 2025 or 2024.
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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