Provider Demographics
NPI:1366513699
Name:COHLMIA, JEFFREY TODD (DDS MS)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:TODD
Last Name:COHLMIA
Suffix:
Gender:M
Credentials:DDS MS
Other - Prefix:DR
Other - First Name:JEFF
Other - Middle Name:
Other - Last Name:COHLMIA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS MS
Mailing Address - Street 1:5025 GAILLARDIA CORPORATE PL STE A
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73142-1892
Mailing Address - Country:US
Mailing Address - Phone:405-751-0300
Mailing Address - Fax:405-751-0966
Practice Address - Street 1:5025 GAILLARDIA CORPORATE PL STE A
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73142-1892
Practice Address - Country:US
Practice Address - Phone:405-751-0300
Practice Address - Fax:405-751-0966
Is Sole Proprietor?:No
Enumeration Date:2006-11-10
Last Update Date:2022-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK49661223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics