Jack D Cooper

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

4005 Issued in NE

Legal business name

JACK D COOPER

Practice address

705 N 17TH Ave
Ashland, NE 68003-1209

Phone

(402) 944-3305

Fax

(402) 944-7611

NPI assigned

Aug 24, 2016

Last updated

Aug 24, 2016By 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

Kayla C Kobs

Title

Office Manager

Phone

(402) 944-3305

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1471996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1471996800000",
    "number": "1891240495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "705 N 17TH AVE",
            "city": "ASHLAND",
            "state": "NE",
            "postal_code": "680031209",
            "telephone_number": "402-944-3305",
            "fax_number": "402-944-7611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 N 17TH AVE",
            "city": "ASHLAND",
            "state": "NE",
            "postal_code": "680031209",
            "telephone_number": "402-944-3305",
            "fax_number": "402-944-7611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACK D COOPER",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-24",
        "last_updated": "2016-08-24",
        "status": "A",
        "authorized_official_last_name": "KOBS",
        "authorized_official_first_name": "KAYLA",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "402-944-3305"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NE",
            "license": "4005",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Ashland, NE
• Providers in Ashland, NE by specialty
• General Practice Dentistry in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2016; 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.