DR. JERRY M COOK (NPI# 1114074960) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114074960 |
| Entity Type | Individual |
| Full Name | DR. JERRY M COOK |
| Credential | DDS |
| Practice Address |
4710 Amber Valley Parkway S, Ste A Fargo ND 58104 |
| Mailing Address |
4710 Amber Valley Pkwy S, Ste A Fargo ND 58104 |
| Practice Telephone | 7012321956 |
| Practice Fax Number | 7012322226 |
| Mailing Telephone | 7012321956 |
| Mailing Fax Number | 7012322226 |
| Enumeration Date | 2007-01-04 |
| Last Update Date | 2012-07-10 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223E0200X |
Dentist Specialization: Endodontics |
1981 | ND | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ND | BLUE CROSS BLUE SHIELD OF | 949321 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306935788 | Jerry Wayne Cook I | Dentist | 715 Calvin Avery Drive, West Memphis, AR 72301 | 2006-10-12 |
| 1265532642 | Jerry William Cook | Ophthalmology | 7400 Nw Whipple Ln, Kansas City, MO 64152-1856 | 2006-09-25 |
| 1295162188 | Jerry A Cook | Occupational Therapist | 17222 Hospital Blvd, Suite 346, Brooksville, FL 34601-8925 | 2013-10-09 |
| Street Address |
4710 AMBER VALLEY PARKWAY S, STE A |
| City | FARGO |
| State | ND |
| Zip Code | 58104 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043837347 | Pinnacle Therapy & Wellness, Pllc | Physical Therapist | 4500 36th Ave S Suite 100, Fargo, ND 58104 | 2020-07-02 |
| 1619509858 | Patricia Helen Bathie | Counselor | 4243 Auburn Ave., Fargo, ND 58104 | 2020-02-05 |
| 1346892866 | Elizabeth Olis | Registered Nurse | 2633 55th St. S, Apartment 202, Fargo, ND 58104 | 2019-07-15 |
| 1780247023 | Keith Kirimi Ndege | Physical Therapy Assistant | 5225 23rd Ave South, Fargo, ND 58104 | 2019-04-22 |
| 1346728557 | Ms4 Pllc | Pharmacy | 4476 31st Avenue South, Suite #105, Fargo, ND 58104 | 2018-07-31 |
| 1891286977 | Jessica Rae Majidian | Dentist | 3030 49th St S, Fargo, ND 58104 | 2018-05-23 |
| 1821588500 | Alissa Nichole Larson | Pharmacist | 5675 26th Ave S St. 136a, Fargo, ND 58104 | 2018-05-17 |
| 1790297430 | Northern Lights Dental | Dentist | 4150 19th Ave S, Suite 301, Fargo, ND 58104 | 2017-11-03 |
| 1619406733 | Cobalt Rehabilitation Hospital Fargo LLC | Rehabilitation Hospital | 4671 38th Street S, Fargo, ND 58104 | 2017-06-12 |
| 1790210318 | Homefield Health, LLC | Clinic/Center | 4141 31st Ave S., Ste 102, Fargo, ND 58104 | 2017-04-21 |
| Find all providers in zip 58104 | ||||
| Taxonomy Code | 1223E0200X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Endodontics |
| The branch of dentistry that is concerned with the morphology, physiology and pathology of the human dental pulp and periradicular tissues. Its study and practice encompass the basic and clinical sciences including biology of the normal pulp, the etiology, diagnosis, prevention and treatment of diseases and injuries of the pulp and associated periradicular conditions. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437530318 | Cook Endodontics, PC | Dentist | 4710 Amber Valley Pkwy S Ste A, Fargo, ND 58104-8695 | 2015-06-16 |
| 1578848131 | Michael Dean Peterson | Dentist | 4710 Amber Valley Pkwy S, Ste A, Fargo, ND 58104 | 2011-10-14 |
| 1972711331 | Kent Alan Spriggs | Dentist | 2910 University Dr S, Fargo, ND 58103-6032 | 2007-05-18 |
| 1467524496 | Northcreek Dental PC | Dentist | 100 S 4th St, Ste 312, Fargo, ND 58103 | 2006-11-14 |
| 1295255438 | Mikaela Leigh Hazard I | Dentist | 2910 University Dr S, Fargo, ND 58103-6032 | 2017-06-20 |
| 1902007511 | Jay Kirkland Taylor | Dentist | 2910 University Dr S, Fargo, ND 58103-6032 | 2007-05-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326354812 | Michael J Turman | Dentist | 1611 E Century Ave Ste 400, Bismarck, ND 58503-0780 | 2010-08-23 |
| 1841521572 | Delvin Hansen Dds PC | Dentist | 118 9th St W, Harvey, ND 58341-1505 | 2010-01-20 |
| 1043331861 | Steven Wayne Osmond | Dentist | 521 E Main Ave, Suite 100, Bismarck, ND 58501-4418 | 2007-04-02 |
| 1912056268 | Marvin Alan Zerr | Dentist | 117 9th Street West, Harvey, ND 58341 | 2007-01-09 |
| 1568452191 | Delvin Lee Hansen | Dentist | 117 9th St W, Harvey, ND 58341-1504 | 2005-10-25 |
| 1518348499 | Cook Endodontics, PC | Dentist | 3425 S Washington St, Grand Forks, ND 58201-7101 | 2015-06-16 |
| 1124468590 | Custom Endodontics, PC | Dentist | 521 E Main Ave, Suite 100, Bismarck, ND 58501-4418 | 2013-07-01 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.