A Choice Dental Care PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

5765 Issued in KY

Legal business name

A CHOICE DENTAL CARE PLLC

Practice address

111 Fairfax Ave
Louisville, KY 40207-4905

Phone

(502) 895-1171

Fax

(502) 899-7197

NPI assigned

Apr 12, 2007

Last updated

Aug 22, 2020By 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

Dr. Robert Earl Cooper, DMDNPI 1053309435

Title

Ceo

Phone

(502) 895-1171

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Robert Earl Cooper, DMD

  • General Practice Dentistry
  • Louisville, KY
  • NPI 1053309435
  NPD (past) Authorized official

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

{
    "created_epoch": "1176336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1992929954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 FAIRFAX AVE",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402074905",
            "telephone_number": "502-895-1171",
            "fax_number": "502-899-7197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 FAIRFAX AVE",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402074905",
            "telephone_number": "502-895-1171",
            "fax_number": "502-899-7197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "A CHOICE DENTAL CARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "COOPER",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "EARL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "502-895-1171",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KY",
            "license": "5765",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "015370",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Louisville, KY
• Providers in Louisville, KY by specialty
• General Practice Dentistry in Kentucky

• 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.