Michael Cooper, DMD
Individual provider Active NPI Dentist · Red Oak, TX
NPI 1497370332 · NPPES record last updated Oct 24, 2023
Key facts
- NPI
- 1497370332
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 36171 (TX)
- Practice address
- 101 Austin Blvd Ste 100
Red Oak, TX 75154-4661 - Phone
- (972) 617-3508
- NPI assigned
- Jun 16, 2020
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 36171 | TX | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dan Alineum - Grand Prairie PLLC | General Practice | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 36171 | TX | |
| Dentist | 122300000X | 36171 | TX | Yes |
Addresses
Primary practice location
101 Austin Blvd Ste 100
Red Oak, TX 75154-4661
Mailing address
4401 Dandelion LN
Midlothian, TX 76065-3850
Phone (909) 844-7223
Other providers in Red Oak, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 24, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.