Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1386191252 Individual Practitioner Female Practitioner

Dr. Kelly Cooper , DDS

Dentist - General Practice • Jbsa Randolph, TX

Professional Overview & Biography Verified Profile Summary

Dr. Kelly Cooper, DDS is a registered healthcare professional specializing in Dentist - General Practice in Jbsa Randolph, TX. Practice services are available at 221 3RD ST W BLDG 1040 under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

221 3rd St W Bldg 1040

Jbsa Randolph, TX 781504800

Telephone 2106523301

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Jbsa Randolph, TX

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 12.3 Yrs
Regional Practice Density
3 Specialists

Practicing in Jbsa Randolph, TX (10570 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

CMS Verified: 2020-09-24
Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License TX 32365

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

Secondary Practice Locations

151 Bodin Cir

Travis Afb, CA 945351801

Phone: 7074237008

224 W D.l. Ingram Ave, Bldg 1408

Cannon Afb, NM 88103

Phone: 5757844041

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners
NPI 1013365832

Doctor of Medicine (M.D.)

Timothy Erhardt , LICSW, LCSW

Social Worker - Clinical

NPI 1043481716

Licensed Independent Clinical Social Worker, Licensed Clinical Social Worker

Dr. Mary Ileso , DO

Family Medicine

NPI 1073171641

Doctor of Osteopathic Medicine (D.O.)

Beatrice Arrambide , WHCAPN

Nurse Practitioner - Women's Health

NPI 1104917574
Zizi Zemeheret , LCSW

Social Worker - Clinical

NPI 1134674005

Licensed Clinical Social Worker

NPI 1225376726

Doctor of Medicine (M.D.)

Career & Practice History Timeline

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

9 Historical Events
📍
Updated Practice Location September 24, 2020

Registered at 221 3RD ST W BLDG 1040, JBSA RANDOLPH, TX 781504800 (Tel: 2106523301)

📍
Updated Business Mailing Address September 24, 2020

Registered at 221 3RD ST W BLDG 1040, JBSA RANDOLPH, TX 781504800

📍
Updated Practice Location April 30, 2018

Registered at 224 W D.L. INGRAM AVE, BLDG 1408, CANNON AFB, NM 88103 (Tel: 5757844041)

NPI Profile Active September 07, 2016

NPI status registered as active in NPPES database

📍
Updated Practice Location September 07, 2016

Registered at 151 BODIN CIR, TRAVIS AFB, CA 945351801 (Tel: 7074237008)

📍
Updated Business Mailing Address September 07, 2016

Registered at 168 FAITH DR, SAN ANTONIO, TX 782282340

👤
Provider Name / Credentials Updated September 07, 2016

Recorded as KELLY COOPER, D.D.S.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) September 07, 2016

Dentist (License #32365 in TX)

🟢
Initial NPI Registration & Enumeration September 07, 2016

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: 1386191252
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: September 07, 2016
Last Update: September 24, 2020
Sole Proprietor: No

Mailing Address

221 3rd St W Bldg 1040

Jbsa Randolph, TX 781504800

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.