MEDICARE: OWEN COHEN

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	8072	NV
2	122300000X	Dentist	14008927-9926	UT

General Provider Information

NPI Number	:	1700587391
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	OWEN COHEN

Provider Business Mailing Address
First Line	:	2000 N FASHION SHOW DR UNIT 4700
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89109-1615
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4 SUNSET WAY
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89014-2015
Country	:	US
Telephone Number	:	702-968-6628
Fax Number	:

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

Provider Enumeration Date	:	03/13/2023
Last Update Date	:	12/12/2025

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Directions to “ OWEN COHEN ” Practice Location

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