Jeril Ransom Cooper IV, DMD

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

DN012766 Issued in GA

Practice address

4610 Brainerd Rd
Suite 3
Chattanooga, TN 37411-3836

Phone

(423) 622-4173

Fax

(423) 629-9889

NPI assigned

Nov 17, 2006

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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 and National Provider Directory roles.

• Pediatric Dentistry and Orthodontics of Chattanooga

  • Pediatric Dentistry
  • Chattanooga, TN
  • NPI 1710442074

  Orthodontics and Dentofacial Orthopedics

  NPD (past)

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

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1384473600000",
    "number": "1437223849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4610 BRAINERD RD",
            "address_2": "SUITE 3",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374113836",
            "telephone_number": "423-622-4173",
            "fax_number": "423-629-9889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4610 BRAINERD RD",
            "address_2": "SUITE 3",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374113836",
            "telephone_number": "423-622-4173",
            "fax_number": "423-629-9889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOPER",
        "first_name": "JERIL",
        "middle_name": "RANSOM",
        "name_prefix": "Dr.",
        "name_suffix": "IV",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-17",
        "last_updated": "2013-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "TN",
            "license": "DS8468",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "GA",
            "license": "DN012766",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Austin Taylor Cooper, AGACNP- BC
• Colton David Cooper, PA-C
• Crystal Cooper, PHARMD
• Heather Michelle Cooper, CRNA
• Jaimee Cooper
• Kayla Patton Cooper, FNP-C
• Lori Ann Cooper
• Melissa Lynn Cooper, SLP-CCC
• Krista Ann Cope, PHARMD, RD, LDN
• Jacy Tucker Copeland, PHARM D

• Orthodontics and Dentofacial Orthopedics Dentistry in Chattanooga, TN
• Providers in Chattanooga, TN by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2013; 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.