Provider Demographics
NPI:1427336171
Name:COHEN, REBECCA (DDS)
Entity type:Individual
Prefix:DR
First Name:REBECCA
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 1:323 S DOHENY DR APT 406
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90048-3782
Mailing Address - Country:US
Mailing Address - Phone:310-595-5575
Mailing Address - Fax:
Practice Address - Street 1:323 S DOHENY DR APT 406
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90048-3782
Practice Address - Country:US
Practice Address - Phone:310-595-5575
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-29
Last Update Date:2011-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA604841223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry