Todd Daniel Cooper, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

MD14501 Issued in MD

Practice address

21534 Great Mills Rd
Lexington PK, MD 20653

Phone

(301) 862-3900

Fax

(301) 862-3779

NPI assigned

Jul 21, 2009

Last updated

May 17, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MD

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Tidewater LLC

  • Dentist
  • Prince Frederick, MD
  • NPI 1306359054
  NPD (past)
• Tidewater LLC

  • General Practice Dentistry
  • Dunkirk, MD
  • NPI 1437643384
  NPD (past)
• Tidewater LLC

  • Dentist
  • Lanham, MD
  • NPI 1609366756
  NPD (past)

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

{
    "created_epoch": "1248134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715904000000",
    "number": "1306076682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21534 GREAT MILLS RD",
            "city": "LEXINGTON PK",
            "state": "MD",
            "postal_code": "20653",
            "telephone_number": "301-862-3900",
            "fax_number": "301-862-3779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21534 GREAT MILLS RD",
            "city": "LEXINGTON PK",
            "state": "MD",
            "postal_code": "20653",
            "telephone_number": "301-862-3900",
            "fax_number": "301-862-3779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOPER",
        "first_name": "TODD",
        "middle_name": "DANIEL",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-21",
        "last_updated": "2024-05-17",
        "certification_date": "2024-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MD",
            "license": "MD14501",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "MD",
            "license": "14501",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Abode Care Partners Al VB, LLC
• Nkiangu Alethia
• David Jack Cooper, DDS
• Elizabeth Ann Fryman, CRNP
• HQM of Bayside, LLC (Bayside Care Center at Lexington Park)
• LP Lexington Park LLC (Chesapeake Shores)
• Rita Mformen
• Novus Pain Management - Maryland, LLC

• Dentist in Lexington PK, MD
• Providers in Lexington PK, MD by specialty
• Dentist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.