Healthcare Provider Details

I. General information

NPI: 1871412460
Provider Name (Legal Business Name): JEFFREY M. COHEN DDS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/15/2026
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4403 E LOS COYOTES DIAGONAL
LONG BEACH CA
90815-2820
US

IV. Provider business mailing address

3410 N LOS COYOTES DIA
LONG BEACH CA
90808-2915
US

V. Phone/Fax

Practice location:
  • Phone: 562-425-6611
  • Fax:
Mailing address:
  • Phone: 562-420-3158
  • Fax: 562-420-2957

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: JEFFREY MARC COHEN
Title or Position: OWNER, DENTIST
Credential: DDS
Phone: 562-420-3158