NPIMap

Organization Active NPI

Wyoming Cosmetic and Family Dental

  • Dentist
  • Cheyenne, WY
National Provider Identifier
1194205401
Registry record updated Aug 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
1199 Issued in WY
Legal business name
WYOMING COSMETIC AND FAMILY DENTAL
Practice address
4620 Grandview Ave
Suite #101
Cheyenne, WY 82009
Phone
(307) 635-2419
Fax
(307) 772-3443
NPI assigned
Aug 16, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2018

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

Authorized official

Name
Jason Whiting, DMD
Title
Owner
Phone
(307) 635-2419

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X 1199 WY Primary
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X 1490 WY

Addresses

Primary practice location

4620 Grandview Ave
Suite #101
Cheyenne, WY 82009

Mailing address

4620 Grandview Ave
Suite 101
Cheyenne, WY 82009
Phone (307) 635-2419

National Provider Directory

National Provider Directory
Tax ID family
Wyoming Cosmetic and Family Dental2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

4620 Grandview Ave
Ste 101
Cheyenne, WY 82009
Phone (307) 635-2419

NPI Registry JSON

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

{
    "created_epoch": "1534377600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1534377600000",
    "number": "1194205401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4620 GRANDVIEW AVE",
            "address_2": "SUITE 101",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "82009",
            "telephone_number": "307-635-2419",
            "fax_number": "307-772-3443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4620 GRANDVIEW AVE",
            "address_2": "SUITE #101",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "82009",
            "telephone_number": "307-635-2419",
            "fax_number": "307-772-3443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WYOMING COSMETIC AND FAMILY DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-16",
        "last_updated": "2018-08-16",
        "status": "A",
        "authorized_official_last_name": "WHITING",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "307-635-2419",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "WY",
            "license": "1199",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "WY",
            "license": "1490",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cheyenne, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2018; 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.