NPIMap

Organization Active NPI

Todd Cooper, DDS, Tyson Teeples, DMD, MD, Ryan Toponce, DMD, PS.

  • Oral and Maxillofacial Surgery (Dentist)
  • Kennewick, WA
National Provider Identifier
1487728614
Registry record updated Jun 21, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
6293 Issued in WA
Legal business name
TODD COOPER, DDS, TYSON TEEPLES, DMD, MD, RYAN TOPONCE, DMD, PS.
Practice address
512 N Young St
Kennewick, WA 99336-7806
Phone
(509) 783-7600
Fax
(509) 783-0774
NPI assigned
Nov 20, 2006
Last updated
Jun 21, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2017

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

Authorized official

Name
Dr. Todd C Cooper, DDSNPI 1871523183
Title
Partner
Phone
(509) 783-7600

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
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X SINGLE SPECIALTY GROUP 1223S0112X 6293 WA Primary

Addresses

Primary practice location

512 N Young St
Kennewick, WA 99336-7806

Mailing address

512 N Young St
Kennewick, WA 99336-7806
Phone (509) 783-7600

Other names 2

  • Columbia Basin Oral & Maxillofacial Surgeons Other name
  • Columbia Basin Oral and Maxillofacial Surgeons Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040227000915 WA Part B Supplier - Clinic/Group Practice 9739076431 Receives reassigned benefits from 1 practitioner
Practice locations: Kennewick, WA

National Provider Directory

National Provider Directory

Locations

512 N Young St
Kennewick, WA 99336
Phone (509) 572-2605

Practitioners & affiliated clinicians

Practitioners 4

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": "1163980800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1498003200000",
    "number": "1487728614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "512 N YOUNG ST",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993367806",
            "telephone_number": "509-783-7600",
            "fax_number": "509-783-0774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "512 N YOUNG ST",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993367806",
            "telephone_number": "509-783-7600",
            "fax_number": "509-783-0774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TODD COOPER, DDS, TYSON TEEPLES, DMD, MD, RYAN TOPONCE, DMD, PS.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-20",
        "last_updated": "2017-06-21",
        "status": "A",
        "authorized_official_last_name": "COOPER",
        "authorized_official_first_name": "TODD",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "509-783-7600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "WA",
            "license": "6293",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Columbia Basin Oral & Maxillofacial Surgeons",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Columbia Basin Oral and Maxillofacial Surgeons",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Kennewick, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.