Healthcare Provider Details

I. General information

NPI: 1467139360
Provider Name (Legal Business Name): HANNAH COOPERMAN DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2023
Last Update Date: 07/30/2025
Certification Date: 07/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

360 BROCKTON AVE APT 204
ABINGTON MA
02351-2186
US

IV. Provider business mailing address

32 TRAVELER ST UNIT 309
BOSTON MA
02118-2843
US

V. Phone/Fax

Practice location:
  • Phone: 781-347-5898
  • Fax:
Mailing address:
  • Phone: 914-355-6015
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License NumberDN10000359
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: