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Contact Information

JORDAN T COOPER, DDS
308 N JAMES ST
JACKSONVILLE, AR72076-4018
 Phone: 501-982-7547
 Fax: 501-985-8421
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Dentist

122300000X
 

General Practice

1223G0001X
Indicates primary specialty

NPI Profile & details for JORDAN T COOPER · (Male)

NPI # 1588725204
Status Active
Credentials DDS (Doctor of Dental Surgery)
Entity Individual
Enumeration date 12/13/2006
Last updated 09/23/2021 - About 5 years ago
Sole proprietor 1 No
Identifiers
  • AR License # 3535
  • AR License # 3565
  • AR Medicaid 164868608
  • AR Other 5Y893 BLUE CROSS BLUE SHIELD
  • AR Other 1874975 UNITED CONCORDIA
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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