Provider Demographics
NPI:1457523797
Name:DR ALKA V COHEN DDS MS PC
Entity Type:Organization
Organization Name:DR ALKA V COHEN DDS MS PC
Other - Org Name:COHEN PEDIATRIC DENTISTRY
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT/OWNER/PEDIATRIC DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ALKA
Authorized Official - Middle Name:VISHNU
Authorized Official - Last Name:COHEN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS MS
Authorized Official - Phone:901-756-4447
Mailing Address - Street 1:8142 COUNTRY VILLAGE DR
Mailing Address - Street 2:SUITE 101
Mailing Address - City:CORDOVA
Mailing Address - State:TN
Mailing Address - Zip Code:38016-2029
Mailing Address - Country:US
Mailing Address - Phone:901-756-4447
Mailing Address - Fax:901-756-8784
Practice Address - Street 1:8142 COUNTRY VILLAGE DR
Practice Address - Street 2:SUITE 101
Practice Address - City:CORDOVA
Practice Address - State:TN
Practice Address - Zip Code:38016-2029
Practice Address - Country:US
Practice Address - Phone:901-756-4447
Practice Address - Fax:901-756-8784
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-27
Last Update Date:2008-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN0016004OtherDORAL PROVIDER NUMBER
TN3207374Medicaid