Andrew Wayne Cooper, DMD
Individual provider Active NPI Dentist · Stanford, KY
NPI 1942986658 · NPPES record last updated Jun 26, 2023
Key facts
- NPI
- 1942986658
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 10919 (KY)
- Practice address
- 603 Lancaster St
Stanford, KY 40484-1248 - Phone
- (606) 365-7803
- NPI assigned
- Jun 26, 2023
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10919 | KY | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| John Shea Lair, D.M.D., PLLC | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 10919 | KY | Yes |
Addresses
Primary practice location
603 Lancaster St
Stanford, KY 40484-1248
Mailing address
1414 Ky Highway 590
Stanford, KY 40484-8279
Phone (606) 669-7761
Other providers in Stanford, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 26, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.