Pinedale Dental

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

PINEDALE DENTAL

Practice address

33 Fremont Lake Rd
Pinedale, WY 82941-5213

Phone

(307) 367-3700

Fax

(307) 312-2848

NPI assigned

Jan 5, 2022

Organization subpart

No

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

Authorized official

Name

Alison Petersen

Title

Receptionist

Phone

(307) 367-3700

Specialties & licenses 1

Addresses

Other identifiers 2

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kevin L Kunard, DDS

  • General Practice Dentistry
  • Pinedale, WY
  • NPI 1427171446
  NPD
• Eric Shultz, D. M. D

  • General Practice Dentistry
  • Pinedale, WY
  • NPI 1578237541
  NPD
• Gregory R McGee, D.M.D.

  • Oral and Maxillofacial Surgery (Dentist)
  • Idaho Falls, ID
  • NPI 1891756367
  NPD (past)

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

{
    "created_epoch": "1641340800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1641340800000",
    "number": "1033870779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1190",
            "city": "PINEDALE",
            "state": "WY",
            "postal_code": "829411190",
            "telephone_number": "307-367-3700",
            "fax_number": "307-312-2848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 FREMONT LAKE RD",
            "city": "PINEDALE",
            "state": "WY",
            "postal_code": "829415213",
            "telephone_number": "307-367-3700",
            "fax_number": "307-312-2848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINEDALE DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-05",
        "last_updated": "2022-01-05",
        "certification_date": "2022-01-05",
        "status": "A",
        "authorized_official_last_name": "PETERSEN",
        "authorized_official_first_name": "ALISON",
        "authorized_official_title_or_position": "RECEPTIONIST",
        "authorized_official_telephone_number": "307-367-3700"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "207753100",
            "state": "WY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "113694100",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Andrew G Nelson, DC
• Megan Elizabeth O'Brien, MSW, LCSW
• Shanna Pearce
• Rauli Jo Perry, WHNP-BC
• Pinedale Chiropractic Center P.C.
• Precise Mind Behavioral LLC
• Aaron J. Preece, LPC
• Proactive Physical Therapy PC
• Laura Tomasita Ramnarine, SLP
• Jeanne Marie Raney, MA CCCSLP

• General Practice Dentistry in Pinedale, WY
• Providers in Pinedale, WY by specialty
• General Practice Dentistry in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2022; 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.