Goose Creek Dental Clinic

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

GOOSE CREEK DENTAL CLINIC

Practice address

642 Val Vista St Ste B
Sheridan, WY 82801-3660

Phone

(307) 655-8661

Fax

(307) 655-8662

NPI assigned

Jul 25, 2018

Organization subpart

No

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

Authorized official

Name

Mrs. Monica Burridge

Title

Practice Manager

Phone

(307) 655-8661

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1532476800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1532476800000",
    "number": "1215414875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "642 VAL VISTA ST STE B",
            "city": "SHERIDAN",
            "state": "WY",
            "postal_code": "828013660",
            "telephone_number": "307-655-8661",
            "fax_number": "307-655-8662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "642 VAL VISTA ST STE B",
            "city": "SHERIDAN",
            "state": "WY",
            "postal_code": "828013660",
            "telephone_number": "307-655-8661",
            "fax_number": "307-655-8662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOOSE CREEK DENTAL CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-25",
        "last_updated": "2018-07-25",
        "status": "A",
        "authorized_official_last_name": "BURRIDGE",
        "authorized_official_first_name": "MONICA",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "307-655-8661",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Global Life Virtual Stress & Lifestyle Wellness Services
• Luke Andrew Goddard, M.D.
• Wendy Sue Goffena, MSW
• Gologo Inc
• Shaun Jeffrey Gonda, MD
• Goose Creek Family Practice, P.C.
• Goose Creek Pediatrics PC
• Lynn Euvoynne Gordon, MS, LPC, NCC
• Nicole C Gore, DMD
• Amy Gorzalka, CCC-SLP

• Clinic/Center in Sheridan, WY
• Providers in Sheridan, WY by specialty
• Clinic/Center in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 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.