Provider Demographics
NPI:1518937374
Name:COHEN, DAVID ELIOT (DDS)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:ELIOT
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 1:11111 NALL AVE
Mailing Address - Street 2:
Mailing Address - City:LEAWOOD
Mailing Address - State:KS
Mailing Address - Zip Code:66211-1625
Mailing Address - Country:US
Mailing Address - Phone:913-491-4900
Mailing Address - Fax:913-491-4996
Practice Address - Street 1:11111 NALL AVE
Practice Address - Street 2:
Practice Address - City:LEAWOOD
Practice Address - State:KS
Practice Address - Zip Code:66211-1620
Practice Address - Country:US
Practice Address - Phone:913-491-4900
Practice Address - Fax:913-491-4996
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS52251223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice