Provider Demographics
NPI:1164645792
Name:BARRY D COHEN DDS PC
Entity Type:Organization
Organization Name:BARRY D COHEN DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BARRY
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:COHEN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:770-394-0002
Mailing Address - Street 1:4721 CHAMBLEE DUNWOODY ROAD
Mailing Address - Street 2:SUITE 200 INDEPENDENCE SQUARE
Mailing Address - City:DUNWOODY
Mailing Address - State:GA
Mailing Address - Zip Code:30338-6000
Mailing Address - Country:US
Mailing Address - Phone:770-394-0002
Mailing Address - Fax:770-394-9605
Practice Address - Street 1:4721 CHAMBLEE DUNWOODY ROAD
Practice Address - Street 2:SUITE 200 INDEPENDENCE SQUARE
Practice Address - City:DUNWOODY
Practice Address - State:GA
Practice Address - Zip Code:30338-6000
Practice Address - Country:US
Practice Address - Phone:770-394-0002
Practice Address - Fax:770-394-9605
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA99141223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Multi-Specialty