NPIMap

Organization Active NPI

Grinnell Street Dental Group

  • General Practice Dentistry
  • Sheridan, WY
National Provider Identifier
1194084897
Registry record updated May 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
WY686 Issued in WY
Legal business name
GRINNELL STREET DENTAL GROUP
Practice address
108 E Grinnell St
Sheridan, WY 82801-3938
Phone
(307) 672-7567
Fax
(307) 673-0568
NPI assigned
May 15, 2012
Last updated
May 15, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 15, 2012

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

Authorized official

Name
Dr. Donald E. Coon, D.D.SNPI 1346457165
Title
General Dentist/President
Phone
(307) 672-7567

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X WY686 WY Primary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X WY1047 WY
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X WY1085 WY

Addresses

Primary practice location

108 E Grinnell St
Sheridan, WY 82801-3938

Mailing address

108 E Grinnell St
Sheridan, WY 82801-3938
Phone (307) 672-7567

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1337040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1337040000000",
    "number": "1194084897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 E GRINNELL ST",
            "city": "SHERIDAN",
            "state": "WY",
            "postal_code": "828013938",
            "telephone_number": "307-672-7567",
            "fax_number": "307-673-0568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 E GRINNELL ST",
            "city": "SHERIDAN",
            "state": "WY",
            "postal_code": "828013938",
            "telephone_number": "307-672-7567",
            "fax_number": "307-673-0568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRINNELL STREET DENTAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-15",
        "last_updated": "2012-05-15",
        "status": "A",
        "authorized_official_last_name": "COON",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "GENERAL DENTIST/PRESIDENT",
        "authorized_official_telephone_number": "307-672-7567",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "WY",
            "license": "WY686",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "WY",
            "license": "WY1047",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "WY",
            "license": "WY1085",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sheridan, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2012; 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.