Roger Willson Cooper, D.D.S.,M.A.

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

D6003 Issued in AZ

Practice address

1625 W Ina Rd
Suite # 103
Tucson, AZ 85704-1900

Phone

(520) 531-8605

Fax

(520) 575-0618

NPI assigned

Jan 16, 2007

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)

Enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1114078136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1625 W INA RD",
            "address_2": "SUITE # 103",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857041900",
            "telephone_number": "520-531-8605",
            "fax_number": "520-575-0618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1625 W INA RD",
            "address_2": "SUITE # 103",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857041900",
            "telephone_number": "520-531-8605",
            "fax_number": "520-575-0618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOPER",
        "first_name": "ROGER",
        "middle_name": "WILLSON",
        "name_prefix": "Dr.",
        "credential": "D.D.S.,M.A.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "AZ",
            "license": "D6003",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kaylee Cooper, PHARMD
• Linda L. Cooper, REGISTERED NURSE
• Lindsey Cooper, LCSW
• Melissa Cooper
• Richard Cooper
• Stephanie Akemi Cooper, O.D.
• Susannah Catherine Cooper, MD
• Thomas Edward Cooper, L.P.C.
• Tracy Uloma Cooper
• Watus Benjamin Cooper Jr., PA-C

• Periodontics in Tucson, AZ
• Providers in Tucson, AZ by specialty
• Periodontics in Arizona

• 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.

Verify at the official NPI Registry.