Provider Demographics
NPI:1275920332
Name:JOHN COHEN, DDS DENTAL CORP
Entity Type:Organization
Organization Name:JOHN COHEN, DDS DENTAL CORP
Other - Org Name:ONE STOP IMPLANTS & DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:COHEN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:562-863-8888
Mailing Address - Street 1:14306 VICTORY BLVD
Mailing Address - Street 2:
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91401-1944
Mailing Address - Country:US
Mailing Address - Phone:562-863-8888
Mailing Address - Fax:562-868-6666
Practice Address - Street 1:11005 FIRESTONE BLVD
Practice Address - Street 2:STE. 106-107
Practice Address - City:NORWALK
Practice Address - State:CA
Practice Address - Zip Code:90650-2224
Practice Address - Country:US
Practice Address - Phone:818-786-6000
Practice Address - Fax:818-786-8820
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-16
Last Update Date:2015-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA40423122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty