Provider Demographics
NPI:1114283223
Name:COSNER, JAVANA (DDS)
Entity Type:Individual
Prefix:DR
First Name:JAVANA
Middle Name:
Last Name:COSNER
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 1:901 TAYLOR ST
Mailing Address - Street 2:STE. A
Mailing Address - City:CHELSEA
Mailing Address - State:MI
Mailing Address - Zip Code:48118-2301
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:901 TAYLOR ST
Practice Address - Street 2:STE. A
Practice Address - City:CHELSEA
Practice Address - State:MI
Practice Address - Zip Code:48118-2301
Practice Address - Country:US
Practice Address - Phone:734-475-7303
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-03
Last Update Date:2012-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901020830122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist