Active NPI
Janelle Cooper, DDS
- Dentist
- Center Line, MI
National Provider Identifier
1477930352
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 2901021623
- Practice address
- 6900 E 10 Mile Rd
Center Line, MI 48015-1168 - Phone
- (586) 467-0980
- NPI assigned
- Apr 30, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Dentist | 122300000X | 2901021623 | MI | Primary |
Addresses
Primary practice location
6900 E 10 Mile Rd
Center Line, MI 48015-1168
Mailing address
811 W Wellington Ave
Chicago, IL 60657-5123
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2901021623 | MI | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1430352000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1516060800000",
"number": "1477930352",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "811 W WELLINGTON AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606575123"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6900 E 10 MILE RD",
"city": "CENTER LINE",
"state": "MI",
"postal_code": "480151168",
"telephone_number": "586-467-0980"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COOPER",
"first_name": "JANELLE",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-04-30",
"last_updated": "2018-01-16",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MI",
"license": "2901021623",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Center Line, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.