Provider Demographics
NPI:1174653042
Name:COHEN, LORI DAWN (DDS)
Entity Type:Individual
Prefix:DR
First Name:LORI
Middle Name:DAWN
Last Name:COHEN
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 1:285 CENTRAL AVE
Mailing Address - Street 2:SUITE F-3
Mailing Address - City:LAWRENCE
Mailing Address - State:NY
Mailing Address - Zip Code:11559-1535
Mailing Address - Country:US
Mailing Address - Phone:516-371-6270
Mailing Address - Fax:516-371-5648
Practice Address - Street 1:285 CENTRAL AVE
Practice Address - Street 2:SUITE F-3
Practice Address - City:LAWRENCE
Practice Address - State:NY
Practice Address - Zip Code:11559-1535
Practice Address - Country:US
Practice Address - Phone:516-371-6270
Practice Address - Fax:516-371-5648
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-07
Last Update Date:2010-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY046819-11223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY113559821OtherTAX ID NUMBER (EIN)
NYU82908Medicare UPIN
NYD27552Medicare PIN