J Selig Cooper DDS PA

Primary specialty

DentistTaxonomy code 122300000X

License

6552 Issued in NC

Legal business name

J SELIG COOPER DDS PA

Practice address

1515 Yanceyville St
Greensboro, NC 27405-6958

Phone

(336) 510-5813

Fax

(336) 510-5812

NPI assigned

Nov 7, 2006

Last updated

May 15, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Javon Selig Cooper, DDSNPI 1043382096

Title

Dentist President

Phone

(336) 510-5813

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 1

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.

• Javon Selig Cooper, DDS

  • Dentist
  • Greensboro, NC
  • NPI 1043382096
  NPD (past) Authorized official

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210809600000",
    "number": "1710056635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 YANCEYVILLE ST",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274056958",
            "telephone_number": "336-510-5813",
            "fax_number": "336-510-5812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 YANCEYVILLE ST",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274056958",
            "telephone_number": "336-510-5813",
            "fax_number": "336-510-5812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "J SELIG COOPER DDS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-07",
        "last_updated": "2008-05-15",
        "status": "A",
        "authorized_official_last_name": "COOPER",
        "authorized_official_first_name": "JAVON",
        "authorized_official_middle_name": "SELIG",
        "authorized_official_title_or_position": "DENTIST PRESIDENT",
        "authorized_official_telephone_number": "336-510-5813",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NC",
            "license": "6552",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "799002F",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSNC PROVIDER #",
            "identifier": "9002F",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Harold N Jacklin, MD

• Dentist in Greensboro, NC
• Providers in Greensboro, NC by specialty
• Dentist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2008; 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.