Bradley B Kincheloe, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

1070 Issued in WY

Practice address

6244 Yellowstone Rd
Cheyenne, WY 82009-3432

Phone

(307) 638-8520

NPI assigned

Mar 23, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Kincheloe & Tonso Family Dentistry LLC

  • General Practice Dentistry
  • Cheyenne, WY
  • NPI 1033574827
  NPD (past) Authorized official
• Kincheloe Dental Office, PC

  • General Practice Dentistry
  • Cheyenne, WY
  • NPI 1881711174
  NPD (past) Authorized official

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

{
    "created_epoch": "1174608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1194842492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2625 WILDHORSE TRL",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820092232",
            "telephone_number": "307-638-6544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6244 YELLOWSTONE RD",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820093432",
            "telephone_number": "307-638-8520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINCHELOE",
        "first_name": "BRADLEY",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WY",
            "license": "1070",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Jung in Kim, PHARMD
• Onjin Kim, M.D.
• Ali Kimyaghalam, M.D.
• Kincheloe & Tonso Family Dentistry LLC
• Kincheloe Dental Office, PC
• Earl B Kincheloe, DDS
• Ryan Gregory Kindervater, D.O.
• King & Associates LLC
• Gary R King, LPC 1227
• Patricia King

• General Practice Dentistry in Cheyenne, WY
• Providers in Cheyenne, WY by specialty
• General Practice Dentistry in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.