NPIMap

Organization Active NPI

GW Cooper and RM Shifman Dental Corporation

  • General Practice Dentistry
  • Ventura, CA
National Provider Identifier
1972574960
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
26831 Issued in CA
Legal business name
GW COOPER AND RM SHIFMAN DENTAL CORPORATION
Practice address
2772 Johnson Dr
Suite 101
Ventura, CA 93003-8582
Phone
(805) 658-1577
Fax
(805) 658-7049
NPI assigned
Jan 30, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Gary W. Cooper, DDS
Title
Shareholder/Director
Phone
(805) 658-1577

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 26831 CA Primary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 50370 CA

Addresses

Primary practice location

2772 Johnson Dr
Suite 101
Ventura, CA 93003-8582

Mailing address

2772 Johnson Dr
Suite 101
Ventura, CA 93003-8582
Phone (805) 658-1577

Other names 1

  • Northbank Dental Center Doing business as

National Provider Directory

National Provider Directory

Locations

2772 Johnson Dr
Ste 101
Ventura, CA 93003
Phone (805) 658-1577

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1138579200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1972574960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2772 JOHNSON DR",
            "address_2": "SUITE 101",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930038582",
            "telephone_number": "805-658-1577",
            "fax_number": "805-658-7049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2772 JOHNSON DR",
            "address_2": "SUITE 101",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930038582",
            "telephone_number": "805-658-1577",
            "fax_number": "805-658-7049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GW COOPER AND RM SHIFMAN DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "COOPER",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "W.",
        "authorized_official_title_or_position": "SHAREHOLDER/DIRECTOR",
        "authorized_official_telephone_number": "805-658-1577",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "26831",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "50370",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Northbank Dental Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ventura, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.