Provider Demographics
NPI:1831286178
Name:COHENCA, NESTOR (DDS)
Entity Type:Individual
Prefix:DR
First Name:NESTOR
Middle Name:
Last Name:COHENCA
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 1:1029 MARKET ST STE 102
Mailing Address - Street 2:
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98033-5585
Mailing Address - Country:US
Mailing Address - Phone:425-440-2000
Mailing Address - Fax:425-785-1130
Practice Address - Street 1:1029 MARKET ST STE 102
Practice Address - Street 2:
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98033-5585
Practice Address - Country:US
Practice Address - Phone:425-440-2000
Practice Address - Fax:425-785-1130
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-06
Last Update Date:2019-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADF00000901223E0200X
WADE600415641223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics