Jerry E Cooper DDS, SC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

6314-015 Issued in WI

Legal business name

JERRY E COOPER DDS, SC

Practice address

1407 N 8TH St
Sheboygan, WI 53081-3400

Phone

(920) 452-1110

Fax

(920) 452-1996

NPI assigned

Mar 1, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Jerry Edward Cooper, D.D.S.

Title

President

Phone

(920) 452-1110

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1298937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1298937600000",
    "number": "1265730287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1407 N 8TH ST",
            "city": "SHEBOYGAN",
            "state": "WI",
            "postal_code": "530813400",
            "telephone_number": "920-452-1110",
            "fax_number": "920-452-1996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1407 N 8TH ST",
            "city": "SHEBOYGAN",
            "state": "WI",
            "postal_code": "530813400",
            "telephone_number": "920-452-1110",
            "fax_number": "920-452-1996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JERRY E COOPER DDS, SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-01",
        "last_updated": "2011-03-01",
        "status": "A",
        "authorized_official_last_name": "COOPER",
        "authorized_official_first_name": "JERRY",
        "authorized_official_middle_name": "EDWARD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "920-452-1110",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "WI",
            "license": "6314-015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lori Ann Jens, CCC-SLP
• Barbara M Jentges, OTR
• Corinne Jepsen-Hobbs, APNP
• Eric B Jerdee
• Jennifer R Jerdee, O.T.R.
• Gina Louise Jetzer, LPN
• Kelly J Jodar, CSAC
• John M Korolewski DDS LLC
• Courtney Johnson, PA-C
• Erin E Johnson, APNP, PMHNP

• Dental Clinic/Center in Sheboygan, WI
• Providers in Sheboygan, WI by specialty
• Dental Clinic/Center in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2011; 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.