James P. Cooley, D.D.S. – General Practice Dentistry

Key facts

NPI: 1124384193
Entity type: Individual (NPI type 1)
Primary specialty: General Practice Dentistry 1223G0001X
License: 2677-15 (WI)
Practice address: 902 Main Street
Cameron, WI 54822-0360
Phone: (715) 458-4470
Fax: (715) 458-4470
NPI assigned: Apr 4, 2012
Sex: Male
Sole proprietor: Yes

Organizations & group practices 1

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.

Cameron Dental Clinic LTD Dentist · Cameron, WI · NPI 1174620330

NPD (past)

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No

State licenses

License	State	Type	Specialty
2677-15	WI	MD	General Practice Dentistry

Practice roles

Organization	Specialty	Status	New patients
Cameron Dental Clinic LTD		Past	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
General Practice Dentistry	1223G0001X	2677-15	WI	Yes

Addresses

Primary practice location

902 Main Street
Cameron, WI 54822-0360

Mailing address

P.O. Box 360
Cameron, WI 54822-0360
Phone (715) 458-4470

Other identifiers

Identifier	Type	State	Issuer
33423600	Other	WI	FORWARD HEALTH (MEDICAL ASSISTANCE)

Other providers in Cameron, WI

All providers in Cameron, WI · General Practice Dentistry in Wisconsin

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 4, 2012. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.