Jerry Edward Cooper, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

7506 Issued in IA

Practice address

708 1St Ave S
Altoona, IA 50009-1717

Phone

(515) 967-6611

NPI assigned

Mar 26, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

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

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

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1396863734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5437 NW 78TH CT",
            "city": "JOHNSTON",
            "state": "IA",
            "postal_code": "501311801",
            "telephone_number": "515-334-9501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "708 1ST AVE S",
            "city": "ALTOONA",
            "state": "IA",
            "postal_code": "500091717",
            "telephone_number": "515-967-6611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOPER",
        "first_name": "JERRY",
        "middle_name": "EDWARD",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IA",
            "license": "7506",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Caitlin Dey Clifford, RBT
• Elizabeth Karen Cole, RD, LD
• Sonya Conlon, DDS
• Connected Life Counseling, LLC
• Jacob Cooper, ARNP, AGNP-C
• Joseph William Coppola Jr., DO
• Jessica Crawford, BCBA
• Megan Crozier, RBT
• Taylor Leigh Culp
• Stanton L Danielson, MD

• General Practice Dentistry in Altoona, IA
• Providers in Altoona, IA by specialty
• General Practice Dentistry in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.