NPIMap

Organization Active NPI

Dr. Jacqueline Cootes, DDS Inc.

  • General Practice Dentistry
  • San Pedro, CA
National Provider Identifier
1245913631
Registry record updated Aug 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
DR. JACQUELINE COOTES, DDS INC.
Practice address
732 W 9TH St Ste 204
San Pedro, CA 90731-3629
Phone
(310) 833-1386
NPI assigned
Aug 10, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2023

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

Authorized official

Name
Dr. Jacqueline Elise Cootes, DDSNPI 1578283321
Title
Owner/President
Phone
(310) 293-9985

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

732 W 9TH St Ste 204
San Pedro, CA 90731-3629

Mailing address

42 Eastfield Dr
Rolling Hills, CA 90274-5262
Phone (310) 293-9985

National Provider Directory

National Provider Directory

Locations

732 W 9th St
Ste 204
San Pedro, CA 90731
Phone (310) 833-1386

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1691625600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1691625600000",
    "number": "1245913631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42 EASTFIELD DR",
            "city": "ROLLING HILLS",
            "state": "CA",
            "postal_code": "902745262",
            "telephone_number": "310-293-9985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "732 W 9TH ST STE 204",
            "city": "SAN PEDRO",
            "state": "CA",
            "postal_code": "907313629",
            "telephone_number": "310-833-1386"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. JACQUELINE COOTES, DDS INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-10",
        "last_updated": "2023-08-10",
        "certification_date": "2023-08-10",
        "status": "A",
        "authorized_official_last_name": "COOTES",
        "authorized_official_first_name": "JACQUELINE",
        "authorized_official_middle_name": "ELISE",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "310-293-9985",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Pedro, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2023; 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.