NPIMap

Organization Active NPI

Cooper Cosmetic & Family Dentistry

  • Dentist
  • North Charleston, SC
National Provider Identifier
1417165267
Registry record updated Mar 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
4103 Issued in SC
Legal business name
COOPER COSMETIC & FAMILY DENTISTRY
Practice address
4830 Chateau Ave
North Charleston, SC 29405-4806
Phone
(843) 225-8718
Fax
(843) 225-8728
NPI assigned
May 17, 2007
Last updated
Mar 12, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2015

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

Authorized official

Name
Dr. Amy Kathleen Cooper, DMDNPI 1205989142
Title
President
Phone
(843) 225-8718

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 4103 SC Primary

Addresses

Primary practice location

4830 Chateau Ave
North Charleston, SC 29405-4806

Mailing address

4830 Chateau Ave
North Charleston, SC 29405-4806
Phone (843) 225-8718

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, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1426118400000",
    "number": "1417165267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4830 CHATEAU AVE",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "294054806",
            "telephone_number": "843-225-8718",
            "fax_number": "843-225-8728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4830 CHATEAU AVE",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "294054806",
            "telephone_number": "843-225-8718",
            "fax_number": "843-225-8728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COOPER COSMETIC & FAMILY DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-17",
        "last_updated": "2015-03-12",
        "status": "A",
        "authorized_official_last_name": "COOPER",
        "authorized_official_first_name": "AMY",
        "authorized_official_middle_name": "KATHLEEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "843-225-8718",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "SC",
            "license": "4103",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Charleston, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2015; 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.