MEDICARE: DR. STEVEN J COHEN D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	11979	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1760409338
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEVEN J COHEN D.D.S.

Provider Business Mailing Address
First Line	:	1026 EAST 152 ND ST. BOX
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44110-3330
Country	:	US
Telephone Number	:	216-681-0055
Fax Number	:

Provider Business Practice Location Address
First Line	:	1026 E 152ND ST
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44110-3330
Country	:	US
Telephone Number	:	216-681-0055
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/17/2006
Last Update Date	:	07/09/2007

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