Provider Demographics
NPI:1780600106
Name:DEAN, SARA KOHEN (DMD)
Entity type:Individual
Prefix:DR
First Name:SARA
Middle Name:KOHEN
Last Name:DEAN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 N OLD KINGS RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:ORMOND BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32174-9505
Mailing Address - Country:US
Mailing Address - Phone:386-672-2590
Mailing Address - Fax:386-672-9041
Practice Address - Street 1:106 N OLD KINGS RD
Practice Address - Street 2:SUITE A
Practice Address - City:ORMOND BEACH
Practice Address - State:FL
Practice Address - Zip Code:32174-9505
Practice Address - Country:US
Practice Address - Phone:386-672-2590
Practice Address - Fax:386-672-9041
Is Sole Proprietor?:No
Enumeration Date:2006-07-15
Last Update Date:2022-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC40271223G0001X
FL167061223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice