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Deactivated NPI 1124247168 Deactivated / Inactive NPI Male Practitioner

Dr. Coolridge Coleman , DDS

Dentist • Jasper, TX

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Coolridge Coleman has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date April 25, 2007
NPI Deactivation Date January 12, 2022
Total Practice Duration ~15 Years of Practice (2007 – 2022)

Professional Overview & Biography Verified Profile Summary

Dr. Coolridge Coleman, DDS was a registered Dentist practicing in Jasper, TX. Throughout an active medical career spanning 15 years, Dr. Coleman provided care at the practice location at 1558 N FLETCHER ST until profile deactivation on 2022-01-12.

Practice Location & Contact Primary Location

Practice Address

1558 N Fletcher St

Jasper, TX 759512603

Telephone 4093846463
Fax 4093845132

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist in Jasper, TX

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 18.7 Yrs
Regional Practice Density
3 Specialists

Practicing in Jasper, TX (6851 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Dentist Primary Specialty

NUCC Taxonomy Code: 122300000X

State License TX 12951

A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated January 12, 2022

Record deactivated on January 12, 2022

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

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Updated Practice Location July 08, 2007

Registered at 1558 N FLETCHER ST, JASPER, TX 759512603 (Tel: 4093846463)

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Updated Business Mailing Address July 08, 2007

Registered at PO BOX 1941, JASPER, TX 759510020 (Tel: 4093846463)

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Provider Name / Credentials Updated July 08, 2007

Recorded as COOLRIDGE COLEMAN, D.D.S.

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Dentist (License #12951 in TX)

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Initial NPI Registration & Enumeration April 25, 2007

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1124247168
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: April 25, 2007
Last Update: July 08, 2007
Deactivation Date: January 12, 2022

Mailing Address

Po Box 1941

Jasper, TX 759510020

Phone: 4093846463

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.