Derrik Walton DDS & Darren J. Ruesch DDS, PC

Key facts

NPI

1154523728

Entity type

Organization (NPI type 2)

Primary specialty

General Practice Dentistry 1223G0001X

License

1008 & 1135 (WY)

Legal business name

DERRIK WALTON DDS & DARREN J. RUESCH DDS, PC

Practice address

1525 Bleistein Ave
Cody, WY 82414-3806

Phone

(307) 587-2951

Fax

(307) 587-2760

NPI assigned

Jun 4, 2007

Organization subpart

No

Authorized official

Name

Dr. Derrik P Walton, DDS NPI 1013017136

Title

President

Phone

(307) 587-2951

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Practitioners 2

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

• Derrik Porter Walton, D.D.S. General Practice Dentistry · Cody, WY · NPI 1013017136
  NPD (past) Authorized official GENERAL PRACTICE
• Darren Jan Ruesch, DDS General Practice Dentistry · Cody, WY · NPI 1811098775
  NPD (past) GENERAL PRACTICE

National Provider Directory

Locations

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Aug 22, 2020.

{
    "created_epoch": "1180915200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1154523728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1525 BLEISTEIN AVE",
            "city": "CODY",
            "state": "WY",
            "postal_code": "824143806",
            "telephone_number": "307-587-2951",
            "fax_number": "307-587-2760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1525 BLEISTEIN AVE",
            "city": "CODY",
            "state": "WY",
            "postal_code": "824143806",
            "telephone_number": "307-587-2951",
            "fax_number": "307-587-2760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DERRIK WALTON DDS & DARREN J. RUESCH DDS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WALTON",
        "authorized_official_first_name": "DERRIK",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "307-587-2951",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "WY",
            "license": "1008 & 1135",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cody, WY

• Megan Davis, PMHNP
• Connor Ross Deal, M.D.
• Rebecca Anne Deal, M.D.
• Tarra Louisa Deiter-Enright, D.O.
• Glenis A Denney
• Jacob G Despain, O.D.
• Misty A Di Meglio
• Chelsea Dillahunty
• Leyla Dim, LPC
• Kathleen Ann Divincenzo, M.D.

All providers in Cody, WY · General Practice Dentistry in Wyoming