Active NPI
Daniel J Morrison, DDS
- Dentist
- Gillette, WY
National Provider Identifier
1164575676
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 1214
- Practice address
- 417 W Flying Circle Dr
Gillette, WY 82716-4701 - Phone
- (307) 682-3353
- Fax
- (307) 687-2861
- NPI assigned
- Jan 19, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | M816 | SD | |
| Dentist | 122300000X | 1214 | WY | Primary |
Addresses
Primary practice location
417 W Flying Circle Dr
Gillette, WY 82716-4701
Mailing address
417 W Flying Circle Dr
Gillette, WY 82716-4701
Phone (307) 682-3353
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7803450 | Medicaid | SD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1214 | WY | MD | Dentist |
| M816 | SD | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169164800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1434412800000",
"number": "1164575676",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "417 W FLYING CIRCLE DR",
"city": "GILLETTE",
"state": "WY",
"postal_code": "827164701",
"telephone_number": "307-682-3353",
"fax_number": "307-687-2861"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "417 W FLYING CIRCLE DR",
"city": "GILLETTE",
"state": "WY",
"postal_code": "827164701",
"telephone_number": "307-682-3353",
"fax_number": "307-687-2861"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MORRISON",
"first_name": "DANIEL",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-19",
"last_updated": "2015-06-16",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "SD",
"license": "M816",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "WY",
"license": "1214",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7803450",
"state": "SD"
}
],
"endpoints": [],
"other_names": []
}Other providers in Gillette, WY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.