Provider Demographics
NPI:1861669004
Name:COHEN, MAHROUZ (DDS)
Entity Type:Individual
Prefix:DR
First Name:MAHROUZ
Middle Name:
Last Name:COHEN
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 1:16311 VENTURA BLVD STE 1290
Mailing Address - Street 2:
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91436-4389
Mailing Address - Country:US
Mailing Address - Phone:818-788-9977
Mailing Address - Fax:818-788-9192
Practice Address - Street 1:16311 VENTURA BLVD STE 1290
Practice Address - Street 2:
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91436-4389
Practice Address - Country:US
Practice Address - Phone:818-788-9977
Practice Address - Fax:818-788-9192
Is Sole Proprietor?:No
Enumeration Date:2008-05-15
Last Update Date:2020-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA410691223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics