Cooper Mountain Dental LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D8822 Issued in OR

Legal business name

COOPER MOUNTAIN DENTAL LLC

Practice address

11471 SW Scholls Ferry Rd
Beaverton, OR 97008-7168

Phone

(503) 356-1078

NPI assigned

Oct 23, 2014

Last updated

Oct 23, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Banu Ramkrishna, DMD

Title

Owner Dentist

Phone

(503) 356-1078

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1414022400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1414022400000",
    "number": "1154726917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11471 SW SCHOLLS FERRY RD",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970087168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11471 SW SCHOLLS FERRY RD",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970087168",
            "telephone_number": "503-356-1078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COOPER MOUNTAIN DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-23",
        "last_updated": "2014-10-23",
        "status": "A",
        "authorized_official_last_name": "RAMKRISHNA",
        "authorized_official_first_name": "BANU",
        "authorized_official_title_or_position": "OWNER DENTIST",
        "authorized_official_telephone_number": "503-356-1078",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D8822",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rita Debbie Cook, O.D.
• Sadie Cook
• Stefanie M Cook, PSY.D.
• Jean Cooksey, RN
• Julia K Coombs, PT, DPT
• Heather Cooper-Krossman, QMHA
• Austin Cooper, DPT
• Kimberly Cooper
• Shari Cooper
• Cooperative Therapies NW

• General Practice Dentistry in Beaverton, OR
• Providers in Beaverton, OR by specialty
• General Practice Dentistry in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2014; 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.