Mitra Kohan, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

DS0000009759 Issued in TN

Practice address

9200 Chimneyrock Blvd Ste 104
Cordova, TN 38016-2201

Phone

(901) 309-6801

NPI assigned

Apr 17, 2014

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Berryhill Dental Center

  • Dentist
  • Cordova, TN
  • NPI 1952246894
  NPD (past)
• Comfort Zone Dental Center, LLC

  • General Practice Dentistry
  • Cordova, TN
  • NPI 1346496593
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1397692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522972800000",
    "number": "1922428986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9200 CHIMNEYROCK BLVD STE 104",
            "city": "CORDOVA",
            "state": "TN",
            "postal_code": "380162201",
            "telephone_number": "901-309-6801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9200 CHIMNEYROCK BLVD STE 104",
            "city": "CORDOVA",
            "state": "TN",
            "postal_code": "380162201",
            "telephone_number": "901-309-6801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOHAN",
        "first_name": "MITRA",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-04-17",
        "last_updated": "2018-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IA",
            "license": "09147",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TN",
            "license": "DS0000009759",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sheryl Blaiss Kirk, FNP
• Emory Ann Klindworth, APRN
• Andrew Knight IV
• Deborah Kober
• Michael Koenig, DNP, CRNA
• Katie Komada, LMSW
• Corey Konemann, FNP-C
• Kristy Love Counseling
• Kristy Smith
• Kroger Limited Partnership I

• Dentist in Cordova, TN
• Providers in Cordova, TN by specialty
• Dentist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.