Michael W. Cooper, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2569 Issued in AR

Practice address

110 S Inglewood Ave
Russellville, AR 72801-3353

Phone

(479) 968-4477

NPI assigned

Jun 30, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

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.

• Michael W. Cooper, D.D.S., P.a.

  • General Practice Dentistry
  • Russellville, AR
  • NPI 1518038728
  NPD (past) Authorized official

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

{
    "created_epoch": "1214784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214784000000",
    "number": "1073775045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 S INGLEWOOD AVE",
            "city": "RUSSELLVILLE",
            "state": "AR",
            "postal_code": "728013353",
            "telephone_number": "479-968-4477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 S INGLEWOOD AVE",
            "city": "RUSSELLVILLE",
            "state": "AR",
            "postal_code": "728013353",
            "telephone_number": "479-968-4477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOPER",
        "first_name": "MICHAEL",
        "middle_name": "W.",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-06-30",
        "last_updated": "2008-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AR",
            "license": "2569",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matthew Cook, PTA
• Pamela L Cook
• Riley Virginia Cook, PT, DPT
• Melanie Margaret Cooke, LCSW
• Cari D. Cooper, PHARM. D.
• Anna Belle Copeland, COTA/L
• Janet K. Corbett, D.O.
• Chantell Corkern, APRN
• Cornerstone Caregiving East LLC
• Joan Cornwell, CASE MANAGER PARAPRO

• General Practice Dentistry in Russellville, AR
• Providers in Russellville, AR by specialty
• General Practice Dentistry in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2008; 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.