# DR. JORDAN TODD COOPER

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1588725204
- **Gender:** Man
- **Credential:** D.D.S.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 3535 | AR | Yes |
| 1223G0001X | General Practice Dentistry | 3565 | AR | — |

## Other

- **Enumeration date:** 12/13/2006
- **Last updated:** 09/23/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 164868608 | — | AR |
| 01 | — | 1874975 | UNITED CONCORDIA | AR |
| 01 | — | 5Y893 | BLUE CROSS BLUE SHIELD | AR |