Provider Demographics
NPI:1902127897
Name:COHENS GENERAL DENTAL
Entity Type:Organization
Organization Name:COHENS GENERAL DENTAL
Other - Org Name:COHENS GENTLE DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:OFER
Authorized Official - Middle Name:A
Authorized Official - Last Name:COHEN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:718-365-0990
Mailing Address - Street 1:183 W 231ST ST
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10463-5652
Mailing Address - Country:US
Mailing Address - Phone:718-365-0990
Mailing Address - Fax:718-365-7010
Practice Address - Street 1:183 W 231ST ST
Practice Address - Street 2:2ND FLOOR
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10463-5652
Practice Address - Country:US
Practice Address - Phone:718-365-0990
Practice Address - Fax:718-365-7010
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-15
Last Update Date:2010-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02173893Medicaid