=====================================================
General NPI Number Information
=====================================================
NPI Number | 1578409686
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | COPE DENTAL GOLD RIVER INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/29/2026
-----------------------------------------------------
Last Update Date | 04/29/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 11201 GOLD EXPRESS DR STE 101
-----------------------------------------------------
City | GOLD RIVER
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95670-6322
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 916-407-4016
-----------------------------------------------------
Fax | 916-407-4023
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 11201 GOLD EXPRESS DR STE 101
-----------------------------------------------------
City | GOLD RIVER
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95670-6322
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 916-407-4016
-----------------------------------------------------
Fax | 916-407-4023
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | DR. AUSTIN COPE
-----------------------------------------------------
Credential | DDS
-----------------------------------------------------
Telephone | 916-933-9080
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 122300000X
-----------------------------------------------------
Taxonomy Name | Dentist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------