MEDICARE: DR. SAPIR LEAH COHEN DMD

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	122300000X	Dentist	DN27019	FL
2	1223G0001X	General Practice Dentistry	DN27019	FL
3	122300000X	Dentist	DEN.00205285	CO

General Provider Information

NPI Number	:	1912631623
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SAPIR LEAH COHEN DMD

Provider Business Mailing Address
First Line	:	410 N 57TH AVE
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33021-6208
Country	:	US
Telephone Number	:	954-326-3854
Fax Number	:

Provider Business Practice Location Address
First Line	:	620 E OAKLAND PARK BLVD STE 100
Second Line	:
City	:	OAKLAND PARK
State	:	FL
Zip	:	33334-2881
Country	:	US
Telephone Number	:	754-206-5897
Fax Number	:

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

Provider Enumeration Date	:	07/11/2022
Last Update Date	:	08/04/2023

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