Provider Demographics
NPI:1912278417
Name:COHEN, CHLOE LEA (DDS, MS)
Entity type:Individual
Prefix:DR
First Name:CHLOE
Middle Name:LEA
Last Name:COHEN
Suffix:
Gender:F
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:655 S HOPE ST
Mailing Address - Street 2:SUITE #1402
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90017-3237
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:655 S HOPE ST
Practice Address - Street 2:SUITE #1402
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90017-3237
Practice Address - Country:US
Practice Address - Phone:310-435-3052
Practice Address - Fax:310-247-6369
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-16
Last Update Date:2014-03-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA610451223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics