Bradley K Walgren, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

921 Issued in WY

Practice address

3421 E Garfield
Laramie, WY 82070

Phone

(307) 745-8513

Fax

(307) 745-0263

NPI assigned

Jul 11, 2006

Last updated

Feb 16, 2017By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Dental Arts PC

  dba Walgren Dental Arts PC

  • Dental Clinic/Center
  • Laramie, WY
  • NPI 1801337902
  NPD (past) Authorized official

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487203200000",
    "number": "1093749145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3421 E GARFIELD",
            "city": "LARAMIE",
            "state": "WY",
            "postal_code": "82070",
            "telephone_number": "307-745-8513",
            "fax_number": "307-745-0263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3421 E GARFIELD",
            "city": "LARAMIE",
            "state": "WY",
            "postal_code": "82070",
            "telephone_number": "307-745-8513",
            "fax_number": "307-745-0263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALGREN",
        "first_name": "BRADLEY",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-11",
        "last_updated": "2017-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WY",
            "license": "921",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "112311400",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Julianna Wakamatsu
• Kiffany Wake
• Wal-Mart Stores, Inc. (Vision Center 30-1412)
• Jason Wales
• Walgreen Co (Walgreens #15606)
• Kaiden Walk
• Gregory L. Wallace, MD
• Walmart Inc. (Walmart Pharmacy 10-1412)
• Linda M Walsh, LPN
• Megan Walsh

• General Practice Dentistry in Laramie, WY
• Providers in Laramie, 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 Feb 16, 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.