NPIMap

Organization Active NPI

Sheridan Wyo Dental

  • General Practice Dentistry
  • Sheridan, WY
National Provider Identifier
1013330794
Registry record updated Jan 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
1310 Issued in WY
Legal business name
SHERIDAN WYO DENTAL
Practice address
2 N Main St Ste 405
Sheridan, WY 82801-6324
Phone
(307) 672-7439
NPI assigned
Jan 30, 2014
Last updated
Jan 30, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2014

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

Authorized official

Name
Ms. Pat Quist
Title
Business Manager
Phone
(307) 672-2328

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 1310 WY Primary

Addresses

Primary practice location

2 N Main St Ste 405
Sheridan, WY 82801-6324

Mailing address

2 N Main St Ste 405
Sheridan, WY 82801-6324
Phone (307) 672-7439

National Provider Directory

National Provider Directory

Locations

2 N Main St
Ste 405
Sheridan, WY 82801
Phone (307) 672-7439

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1391040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1391040000000",
    "number": "1013330794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 N MAIN ST STE 405",
            "city": "SHERIDAN",
            "state": "WY",
            "postal_code": "828016324",
            "telephone_number": "307-672-7439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 N MAIN ST STE 405",
            "city": "SHERIDAN",
            "state": "WY",
            "postal_code": "828016324",
            "telephone_number": "307-672-7439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHERIDAN WYO DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-30",
        "last_updated": "2014-01-30",
        "status": "A",
        "authorized_official_last_name": "QUIST",
        "authorized_official_first_name": "PAT",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "307-672-2328",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "WY",
            "license": "1310",
            "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 30, 2014; 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.