Provider Demographics
NPI:1558615559
Name:COHEN-GADOL, VICTORIA NONE (DDS)
Entity Type:Individual
Prefix:DR
First Name:VICTORIA
Middle Name:NONE
Last Name:COHEN-GADOL
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 1:502 NORTH MAPLE
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90210
Mailing Address - Country:US
Mailing Address - Phone:310-936-1699
Mailing Address - Fax:310-273-1606
Practice Address - Street 1:502 N MAPLE DR
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90210-3409
Practice Address - Country:US
Practice Address - Phone:310-936-1699
Practice Address - Fax:310-273-1606
Is Sole Proprietor?:No
Enumeration Date:2012-10-30
Last Update Date:2012-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA487131223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice