Individual provider Active NPI

Sierra Danae Cooper, DMD

  • Dentist
  • Jericho, VT
National Provider Identifier
1912647199
Registry record updated Jul 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
016.0134207 Issued in VT
Practice address
22 Raceway Rd
Jericho, VT 05465-2100
Phone
(802) 899-3973
NPI assigned
Mar 29, 2022
Last updated
Jul 26, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 016.0134207 VT Primary
Student in an Organized Health Care Education/Training Program 390200000X NU

Addresses

Primary practice location

22 Raceway Rd
Jericho, VT 05465-2100

Mailing address

22 Raceway Rd
Jericho, VT 05465-2100
Phone (802) 899-3973

Other practice location 1

52 N Prospect St
Burlington, VT 05401-3338
Phone (802) 863-3479

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
016.0134207VTMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Dunkling and Penney Dentistry PastSince Jul 31, 2023 Accepting new patients
Paul D. Dunkling, DDS PastSince Jul 31, 2023 Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1648512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690329600000",
    "number": "1912647199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 RACEWAY RD",
            "city": "JERICHO",
            "state": "VT",
            "postal_code": "054652100",
            "telephone_number": "802-899-3973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 RACEWAY RD",
            "city": "JERICHO",
            "state": "VT",
            "postal_code": "054652100",
            "telephone_number": "802-899-3973"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "52 N Prospect St",
            "address_purpose": "LOCATION",
            "city": "Burlington",
            "state": "VT",
            "postal_code": "054013338",
            "country_code": "US",
            "telephone_number": "802-863-3479",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COOPER",
        "first_name": "SIERRA",
        "middle_name": "DANAE",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-29",
        "last_updated": "2023-07-26",
        "certification_date": "2023-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VT",
            "license": "016.0134207",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jericho, VT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2023; 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.