Provider Demographics
NPI:1952925430
Name:COOPER, CHRISTOPHER (DDS)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:
Last Name:COOPER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7302 GILES RD STE 1
Mailing Address - Street 2:
Mailing Address - City:LA VISTA
Mailing Address - State:NE
Mailing Address - Zip Code:68128-5902
Mailing Address - Country:US
Mailing Address - Phone:402-218-4220
Mailing Address - Fax:402-218-4290
Practice Address - Street 1:7302 GILES RD STE 1
Practice Address - Street 2:
Practice Address - City:LA VISTA
Practice Address - State:NE
Practice Address - Zip Code:68128-5902
Practice Address - Country:US
Practice Address - Phone:402-218-4220
Practice Address - Fax:402-218-4290
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-01
Last Update Date:2023-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE7659122300000X
IADDS-097471223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice