Organization Active NPI

Coopersburg Dental PLLC

  • Dental Clinic/Center
  • Coopersburg, PA
National Provider Identifier
1508453036
Registry record updated Dec 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
COOPERSBURG DENTAL PLLC
Practice address
20 S Main St
Coopersburg, PA 18036-1911
Phone
(610) 282-1700
NPI assigned
Dec 30, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2020

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

Authorized official

Name
Elizabeth Galvin
Title
Billing Manager
Phone
(570) 655-7645

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

20 S Main St
Coopersburg, PA 18036-1911

Mailing address

457 N Main St Ste 100
Pittston, PA 18640-2185
Phone (570) 655-7645

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://drmarycares.com/

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1609286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1609286400000",
    "number": "1508453036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "457 N MAIN ST STE 100",
            "city": "PITTSTON",
            "state": "PA",
            "postal_code": "186402185",
            "telephone_number": "570-655-7645",
            "fax_number": "570-299-7427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 S MAIN ST",
            "city": "COOPERSBURG",
            "state": "PA",
            "postal_code": "180361911",
            "telephone_number": "610-282-1700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COOPERSBURG DENTAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-30",
        "last_updated": "2020-12-30",
        "certification_date": "2020-12-30",
        "status": "A",
        "authorized_official_last_name": "GALVIN",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "570-655-7645"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://drmarycares.com/",
            "affiliation": "N",
            "endpointDescription": "Office",
            "address_1": "20 S Main St",
            "city": "Coopersburg",
            "state": "PA",
            "country_code": "US",
            "postal_code": "180361911",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Coopersburg, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2020; 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.