Gillette Orthodontics LLC

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

1353 Issued in WY

Legal business name

GILLETTE ORTHODONTICS LLC

Practice address

530 Running W Dr
Suite 100
Gillette, WY 82718-2074

Phone

(307) 257-2550

NPI assigned

May 1, 2017

Last updated

May 1, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Brian Ward, DDS, MSD

Title

Owner

Phone

(208) 918-5622

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1493596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1493596800000",
    "number": "1114452836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 RUNNING W DR",
            "address_2": "SUITE 100",
            "city": "GILLETTE",
            "state": "WY",
            "postal_code": "827182074",
            "telephone_number": "307-257-2550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 RUNNING W DR",
            "address_2": "SUITE 100",
            "city": "GILLETTE",
            "state": "WY",
            "postal_code": "827182074",
            "telephone_number": "307-257-2550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GILLETTE ORTHODONTICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-01",
        "last_updated": "2017-05-01",
        "status": "A",
        "authorized_official_last_name": "WARD",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-918-5622",
        "authorized_official_credential": "DDS, MSD"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "WY",
            "license": "1353",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Heidi Gillette, RDN, LD
• Troy Gillette

• Orthodontics and Dentofacial Orthopedics Dentistry in Gillette, WY
• Providers in Gillette, WY by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 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.