Cooper Callaway, DMD MS

Individual provider Active NPI Orthodontics and Dentofacial Orthopedics Dentistry · Starkville, MS

NPI 1740353291 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1740353291
Entity type
Individual (NPI type 1)
Primary specialty
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X
License
2991 97 (MS)
Practice address
100 Starr Ave Ste D
Starkville, MS 39759
Phone
(662) 615-4225
Fax
(662) 615-4288
NPI assigned
Nov 15, 2006
Sex
Male
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
2991 97MSMDOrthodontics and Dentofacial Orthopedic Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Callaway Orthodontics Orthodontics and Dentofacial Orthopedics Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 2991 97 MS Yes

Addresses

Primary practice location

100 Starr Ave Ste D
Starkville, MS 39759

Mailing address

100 Starr Ave
Ste D
Starkville, MS 39759
Phone (662) 615-4225

Other providers in Starkville, MS

All providers in Starkville, MS · Orthodontics and Dentofacial Orthopedics Dentistry in Mississippi

Sources for this page

Verify at the official NPI Registry.