Provider Demographics
NPI:1528061033
Name:COHEN, SHELDON (DDS)
Entity type:Individual
Prefix:DR
First Name:SHELDON
Middle Name:
Last Name:COHEN
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 1:35585 LAKESHORE BLVD
Mailing Address - Street 2:
Mailing Address - City:EASTLAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44095-1963
Mailing Address - Country:US
Mailing Address - Phone:440-946-4050
Mailing Address - Fax:440-946-3716
Practice Address - Street 1:35585 LAKESHORE BLVD
Practice Address - Street 2:
Practice Address - City:EASTLAKE
Practice Address - State:OH
Practice Address - Zip Code:44095-1963
Practice Address - Country:US
Practice Address - Phone:440-946-4050
Practice Address - Fax:440-946-3716
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-05-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH161371223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice