Healthcare Provider Details

I. General information

NPI: 1578409686
Provider Name (Legal Business Name): COPE DENTAL GOLD RIVER INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/29/2026
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11201 GOLD EXPRESS DR STE 101
GOLD RIVER CA
95670-6322
US

IV. Provider business mailing address

11201 GOLD EXPRESS DR STE 101
GOLD RIVER CA
95670-6322
US

V. Phone/Fax

Practice location:
  • Phone: 916-407-4016
  • Fax: 916-407-4023
Mailing address:
  • Phone: 916-407-4016
  • Fax: 916-407-4023

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State

VIII. Authorized Official

Name: DR. AUSTIN COPE
Title or Position: PRESIDENT
Credential: DDS
Phone: 916-933-9080