Creekside Dental LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

CREEKSIDE DENTAL LLC

Practice address

642 Val Vista St
Stuite #a
Sheridan, WY 82801-3659

Phone

(307) 674-9222

Fax

(307) 674-1765

NPI assigned

Aug 28, 2012

Last updated

Dec 31, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Joseph Rollin McColley, D.D.SNPI 1487938858

Title

Owner/Dentist

Phone

(307) 674-9222

Specialties & licenses 1

Addresses

Other names 1

• McColley Family Dentistry Former legal business name

Locations

Practitioners 1

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.

• Joseph Rollin McColley, DDS

  • Dentist
  • Sheridan, WY
  • NPI 1487938858
  NPD (past) Authorized official

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

{
    "created_epoch": "1346112000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1419984000000",
    "number": "1285982025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "642 VAL VISTA ST",
            "address_2": "STUITE #A",
            "city": "SHERIDAN",
            "state": "WY",
            "postal_code": "828013659",
            "telephone_number": "307-674-9222",
            "fax_number": "307-674-1765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "642 VAL VISTA ST",
            "address_2": "STUITE #A",
            "city": "SHERIDAN",
            "state": "WY",
            "postal_code": "828013659",
            "telephone_number": "307-674-9222",
            "fax_number": "307-674-1765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CREEKSIDE DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-28",
        "last_updated": "2014-12-31",
        "status": "A",
        "authorized_official_last_name": "MCCOLLEY",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "ROLLIN",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "307-674-9222",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "McColley Family Dentistry",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• County of Sheridan (Sheridan County Public Health)
• Elizabeth C Craft, HAS
• Jay Thomas Craft, HEARING AID SPEC
• James Craig, JD, MA
• Stephen R Crayton
• Louisa Giuliana Werner Crosby, AGACNP
• Crossroads Health LLC
• Dontae Crow
• Cassidy Crowder
• Leilani Ray Cullen, MA LMFT

• General Practice Dentistry in Sheridan, WY
• Providers in Sheridan, 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 Dec 31, 2014; 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.