Provider Demographics
NPI:1730592429
Name:KOHN, HEATHER SARAH (DDS)
Entity type:Individual
Prefix:DR
First Name:HEATHER
Middle Name:SARAH
Last Name:KOHN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7800 W OAKLAND PARK BLVD STE 106C
Mailing Address - Street 2:
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33351-1121
Mailing Address - Country:US
Mailing Address - Phone:954-871-4474
Mailing Address - Fax:
Practice Address - Street 1:7800 W OAKLAND PARK BLVD STE 106C
Practice Address - Street 2:
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33351-1121
Practice Address - Country:US
Practice Address - Phone:954-871-4474
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-10
Last Update Date:2015-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN20667122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist