NPIMap

Organization Active NPI

Jordan Todd Cooper DDS PA

  • Dental Clinic/Center
  • Jacksonville, AR
National Provider Identifier
1356620702
Registry record updated Aug 16, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
3565 Issued in AR
Legal business name
JORDAN TODD COOPER DDS PA
Doing business as
Cooper Family Dentistry
Practice address
308 N James St
Jacksonville, AR 72076-4018
Phone
(501) 982-7547
Fax
(501) 985-8421
NPI assigned
Aug 16, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2011

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

Authorized official

Name
Dr. Jordan Todd Cooper, DDSNPI 1588725204
Title
President
Phone
(501) 982-7547

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
Dental Clinic/Center 261QD0000X 3565 AR Primary

Addresses

Primary practice location

308 N James St
Jacksonville, AR 72076-4018

Mailing address

308 N James St
Jacksonville, AR 72076-4018
Phone (501) 982-7547

Other identifiers 2

IdentifierTypeStateIssuer
638266OtherARUNITED CONCORDIA
1874975OtherARUNITED CONCORDIA

Other names 1

  • Cooper Family Dentistry Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

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": "1313452800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1313452800000",
    "number": "1356620702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "308 N JAMES ST",
            "city": "JACKSONVILLE",
            "state": "AR",
            "postal_code": "720764018",
            "telephone_number": "501-982-7547",
            "fax_number": "501-985-8421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "308 N JAMES ST",
            "city": "JACKSONVILLE",
            "state": "AR",
            "postal_code": "720764018",
            "telephone_number": "501-982-7547",
            "fax_number": "501-985-8421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JORDAN TODD COOPER DDS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-16",
        "last_updated": "2011-08-16",
        "status": "A",
        "authorized_official_last_name": "COOPER",
        "authorized_official_first_name": "JORDAN",
        "authorized_official_middle_name": "TODD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "501-982-7547",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "AR",
            "license": "3565",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "638266",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "1874975",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cooper Family Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jacksonville, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 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.