Active NPI
Glenn Staton Cook, D.M.D.
- Dentist
- Ocean Springs, MS
National Provider Identifier
1104901628
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 2473-89
- Practice address
- 1000 N Halstead Rd
A
Ocean Springs, MS 39564-3119 - Phone
- (228) 875-4428
- NPI assigned
- Oct 25, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 2473-89 | MS | Primary |
Addresses
Primary practice location
1000 N Halstead Rd
A
Ocean Springs, MS 39564-3119
Mailing address
1000 A North Halstead
Ocean Springs, MS 39564
Phone (228) 875-4428
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2473-89 | MS | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161734400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1104901628",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1000 A NORTH HALSTEAD",
"city": "OCEAN SPRINGS",
"state": "MS",
"postal_code": "39564",
"telephone_number": "228-875-4428"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1000 N HALSTEAD RD",
"address_2": "A",
"city": "OCEAN SPRINGS",
"state": "MS",
"postal_code": "395643119",
"telephone_number": "228-875-4428"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COOK",
"first_name": "GLENN",
"middle_name": "STATON",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-25",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MS",
"license": "2473-89",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ocean Springs, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.