Individual provider Active NPI

Charles-Thomas Cooke, DDS, MS

  • Pediatric Dentistry
  • Charlotte, NC
National Provider Identifier
1962799379
Registry record updated Jul 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
9483 Issued in NC
Practice address
2700 Coltsgate Rd
Suite 204
Charlotte, NC 28211-3799
Phone
(704) 749-5700
Fax
(704) 749-5701
NPI assigned
Jul 6, 2011
Last updated
Jul 20, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X DS039050 PA
Pediatric Dentistry 1223P0221X 9483 NC Primary

Addresses

Primary practice location

2700 Coltsgate Rd
Suite 204
Charlotte, NC 28211-3799

Mailing address

2700 Coltsgate Rd
Suite 204
Charlotte, NC 28211-3799
Phone (704) 749-5700

Other names 1

  • Dr. Charles Cooke Professional name

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
9483NCMDPediatric Dentist
DS039050PAMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Cooke and Mvula, PLLC Pediatric Dentistry Current Accepting new patients
Selden Mvula and Cooke PLLC Current Accepting new patients

Locations

2700 Coltsgate Rd
Ste 204
Charlotte, NC 28211
Phone (704) 749-5700

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": "1309910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721433600000",
    "number": "1962799379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 COLTSGATE RD",
            "address_2": "SUITE 204",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282113799",
            "telephone_number": "704-749-5700",
            "fax_number": "704-749-5701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 COLTSGATE RD",
            "address_2": "SUITE 204",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282113799",
            "telephone_number": "704-749-5700",
            "fax_number": "704-749-5701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOKE",
        "first_name": "CHARLES-THOMAS",
        "name_prefix": "Dr.",
        "credential": "DDS, MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-06",
        "last_updated": "2024-07-20",
        "certification_date": "2024-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "PA",
            "license": "DS039050",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NC",
            "license": "9483",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHARLES",
            "last_name": "COOKE",
            "prefix": "DR.",
            "credential": "DDS, MS",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2024; 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.