London L Cooper, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

5481-015 Issued in WI

Practice address

3504 E Maria Dr
Stevens Point, WI 54481-1334

Phone

(715) 342-8060

Fax

(715) 342-0062

NPI assigned

Aug 8, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Apr 13, 2016 through Apr 13, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1336159763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3504 E MARIA DR",
            "city": "STEVENS POINT",
            "state": "WI",
            "postal_code": "544811334",
            "telephone_number": "715-342-8060",
            "fax_number": "715-342-0062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3504 E MARIA DR",
            "city": "STEVENS POINT",
            "state": "WI",
            "postal_code": "544811334",
            "telephone_number": "715-342-8060",
            "fax_number": "715-342-0062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOPER",
        "first_name": "LONDON",
        "middle_name": "L",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-08",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "5481-015",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33773600",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Compass Chiropractic and Wellness, S.C.
• Compassion Counseling
• Compliance One Labs
• Bria Cook, DPT
• Kristi M Cooley, RD
• Timothy J Cooper, DDS
• Copperleaf Home Health Inc
• Megan B Cordner
• Jeana L. Council, PH.D.
• County of Portage

• Dentist in Stevens Point, WI
• Providers in Stevens Point, WI by specialty
• Dentist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.