Provider Demographics
NPI:1972774008
Name:COHEN, STEVEN L (DDS)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:L
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 1:6541 CROWN BLVD
Mailing Address - Street 2:SUITE H
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95120-2907
Mailing Address - Country:US
Mailing Address - Phone:408-268-8585
Mailing Address - Fax:
Practice Address - Street 1:6541 CROWN BLVD
Practice Address - Street 2:SUITE H
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95120-2907
Practice Address - Country:US
Practice Address - Phone:408-268-8585
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-17
Last Update Date:2008-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA402251223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice