NPIMap

Organization Active NPI

Gillette Pediatric Dentistry LLC

  • Pediatric Dentistry
  • Sheridan, WY
National Provider Identifier
1013289966
Registry record updated Jan 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
1271 Issued in WY
Legal business name
GILLETTE PEDIATRIC DENTISTRY LLC
Practice address
433 Shadow Ridge Blvd
Sheridan, WY 82801-9350
Phone
(307) 670-8118
NPI assigned
Feb 7, 2012
Last updated
Jan 6, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. David Glenn Bailey, D.D.S.
Title
Pediatric Dentist
Phone
(307) 670-8118

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0221X 1271 WY Primary

Addresses

Primary practice location

433 Shadow Ridge Blvd
Sheridan, WY 82801-9350

Mailing address

530 Running W Drive
Suite 100
Gillette, WY 82718-2003
Phone (307) 670-8118

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1328572800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1483660800000",
    "number": "1013289966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 RUNNING W DRIVE",
            "address_2": "SUITE 100",
            "city": "GILLETTE",
            "state": "WY",
            "postal_code": "827182003",
            "telephone_number": "307-670-8118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "433 SHADOW RIDGE BLVD",
            "city": "SHERIDAN",
            "state": "WY",
            "postal_code": "828019350",
            "telephone_number": "307-670-8118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GILLETTE PEDIATRIC DENTISTRY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-07",
        "last_updated": "2017-01-06",
        "status": "A",
        "authorized_official_last_name": "BAILEY",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "GLENN",
        "authorized_official_title_or_position": "PEDIATRIC DENTIST",
        "authorized_official_telephone_number": "307-670-8118",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "WY",
            "license": "1271",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sheridan, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.