| John Cohen D D S Dental Corporation | |
|
10823 Hawthorne Blvd A & B Lennox CA 90304-4317 | |
| (310) 412-8013 | |
| (310) 412-7970 |
| Full Name | John Cohen D D S Dental Corporation |
|---|---|
| Speciality | Clinic/Center |
| Location | 10823 Hawthorne Blvd, Lennox, California |
| Authorized Official Name and Position | John Cohen (DENTIST) |
| Authorized Official Contact | 3104128013 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| John Cohen D D S Dental Corporation 10823 Hawthorne Blvd A & B Lennox CA 90304-4317 Ph: (310) 412-8013 | John Cohen D D S Dental Corporation 10823 Hawthorne Blvd A & B Lennox CA 90304-4317 Ph: (310) 412-8013 |
| NPI Number | 1366686214 |
|---|---|
| Provider Enumeration Date | 04/22/2009 |
| Last Update Date | 09/02/2020 |
| Medicare PECOS PAC ID | 0042644940 |
|---|---|
| Medicare Enrollment ID | O20201008000707 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366686214 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
| Provider Name | Wissam Ayoub |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1053450577 PECOS PAC ID: 8729414164 Enrollment ID: I20200204001230 |
| Provider Name | John Cohen |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1154492379 PECOS PAC ID: 0143648881 Enrollment ID: I20201008000780 |
| Provider Name | Elena Afsaneh Yeganeh-tajian |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1700159050 PECOS PAC ID: 0244650414 Enrollment ID: I20201009001151 |
Paul H Koziol Dental Corporation Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 4500 Lennox Blvd, Lennox, CA 90304 Phone: 310-672-2816 |