Nathan Tanner PC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

NATHAN TANNER PC

Doing business as

Elkridge Dental

Practice address

200 E Broadway
Jackson, WY 83001

Phone

(307) 733-2555

NPI assigned

Oct 10, 2019

Organization subpart

No

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

Authorized official

Name

Lynette Krause

Title

Insurance Coordinator

Phone

(307) 733-2555

Specialties & licenses 1

Addresses

Other names 1

• Elkridge Dental Doing business as

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

{
    "created_epoch": "1570665600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1570665600000",
    "number": "1144862293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1190",
            "city": "JACKSON",
            "state": "WY",
            "postal_code": "830011190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 E BROADWAY",
            "city": "JACKSON",
            "state": "WY",
            "postal_code": "83001",
            "telephone_number": "307-733-2555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NATHAN TANNER PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-10",
        "last_updated": "2019-10-10",
        "status": "A",
        "authorized_official_last_name": "KRAUSE",
        "authorized_official_first_name": "LYNETTE",
        "authorized_official_title_or_position": "INSURANCE COORDINATOR",
        "authorized_official_telephone_number": "307-733-2555"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Elkridge Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mountain Therapy PLLC
• Olivia Louise Mountcastle, RDN LDN MS
• Mary Ann Mullane, PT
• Jacob Wayne Munger, DPT
• McKenzie Suzanne Myers
• Mary C Neal, MD
• William C Neal, M.D.
• Mark Matthew Neimat, M.D.
• Marina G Nell, PT
• Jennifer Nelson-Hawks, NATUROPATHIC DOCTOR

• Dental Clinic/Center in Jackson, WY
• Providers in Jackson, WY by specialty
• Dental Clinic/Center in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2019; 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.