Provider Demographics
NPI:1184829566
Name:COHEN, STEPHEN M (DDS)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:M
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 1:1 PLAZA ST W STE 1A
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11217-3740
Mailing Address - Country:US
Mailing Address - Phone:718-622-2557
Mailing Address - Fax:718-622-2558
Practice Address - Street 1:1 PLAZA ST W STE 1A
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11217-3740
Practice Address - Country:US
Practice Address - Phone:718-622-2557
Practice Address - Fax:718-622-2558
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-18
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY50-029449122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYBC9692698OtherDEA#