Active NPI
James Dale Engstrom, D.D.S.
- General Practice Dentistry
- Rawlins, WY
National Provider Identifier
1245343136
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 995
- Practice address
- 1719 Edinburgh St
Rawlins, WY 82301-4572 - Phone
- (307) 324-2679
- Fax
- (307) 324-4603
- NPI assigned
- Aug 16, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 995 | WY | Primary |
Addresses
Primary practice location
1719 Edinburgh St
Rawlins, WY 82301-4572
Mailing address
1719 Edinburgh St
Rawlins, WY 82301-4572
Phone (307) 324-2679
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 |
|---|---|---|---|
| 995 | WY | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155686400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1245343136",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1719 EDINBURGH ST",
"city": "RAWLINS",
"state": "WY",
"postal_code": "823014572",
"telephone_number": "307-324-2679",
"fax_number": "307-324-4603"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1719 EDINBURGH ST",
"city": "RAWLINS",
"state": "WY",
"postal_code": "823014572",
"telephone_number": "307-324-2679",
"fax_number": "307-324-4603"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ENGSTROM",
"first_name": "JAMES",
"middle_name": "DALE",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-16",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "WY",
"license": "995",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rawlins, WY
Sources for this page
- 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.