Provider Demographics
NPI:1174533665
Name:COHANIM, BABAK (DDS, MS)
Entity type:Individual
Prefix:DR
First Name:BABAK
Middle Name:
Last Name:COHANIM
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:DR
Other - First Name:B
Other - Middle Name:ROBERT
Other - Last Name:COHANIM
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS, MS
Mailing Address - Street 1:600 BROADWAY STE 520
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98122-5396
Mailing Address - Country:US
Mailing Address - Phone:206-322-7223
Mailing Address - Fax:206-322-7263
Practice Address - Street 1:600 BROADWAY STE 520
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98122-5396
Practice Address - Country:US
Practice Address - Phone:206-322-7223
Practice Address - Fax:206-322-7263
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA73661223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics