Provider Demographics
NPI:1528100815
Name:KOKABI, B TAYLOR (DMD)
Entity type:Individual
Prefix:
First Name:B
Middle Name:TAYLOR
Last Name:KOKABI
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 1:205 GREENFIELD CT
Mailing Address - Street 2:
Mailing Address - City:STERLING
Mailing Address - State:VA
Mailing Address - Zip Code:20164-1236
Mailing Address - Country:US
Mailing Address - Phone:703-975-1869
Mailing Address - Fax:
Practice Address - Street 1:8808F PEAR TREE VILLAGE CT
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22309-4221
Practice Address - Country:US
Practice Address - Phone:703-780-2400
Practice Address - Fax:703-780-6099
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA111731223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice