NPIMap

Organization Active NPI

Powder River Dental Associates, LLC

  • General Practice Dentistry
  • Gillette, WY
National Provider Identifier
1295833879
Registry record updated Aug 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
198000183327 Issued in WY
Legal business name
POWDER RIVER DENTAL ASSOCIATES, LLC
Practice address
1211 S Douglas Hwy Ste 200
Gillette, WY 82716-4968
Phone
(307) 682-6771
Fax
(307) 682-9895
NPI assigned
Sep 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2026

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

Authorized official

Name
Dr. Holly Schamber, DDSNPI 1205181138
Title
Owner
Phone
(307) 682-6771

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 198000183327 WY Primary

Addresses

Primary practice location

1211 S Douglas Hwy Ste 200
Gillette, WY 82716-4968

Mailing address

1211 S Douglas Hwy Ste 200
Gillette, WY 82716-4968
Phone (307) 682-6771

Other names 1

  • PRDA, LLC Doing business as

National Provider Directory

National Provider Directory

Locations

805 S 4-J Rd
Gillette, WY 82716
Phone (307) 682-6655

1211 S Douglas Hwy
Ste 200
Gillette, WY 82716
Phone (307) 682-6771

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1786406400000",
    "number": "1295833879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1211 S DOUGLAS HWY STE 200",
            "city": "GILLETTE",
            "state": "WY",
            "postal_code": "827164968",
            "telephone_number": "307-682-6771",
            "fax_number": "307-682-9895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1211 S DOUGLAS HWY STE 200",
            "city": "GILLETTE",
            "state": "WY",
            "postal_code": "827164968",
            "telephone_number": "307-682-6771",
            "fax_number": "307-682-9895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POWDER RIVER DENTAL ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2026-08-11",
        "certification_date": "2026-08-11",
        "status": "A",
        "authorized_official_last_name": "SCHAMBER",
        "authorized_official_first_name": "HOLLY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "307-682-6771",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "WY",
            "license": "198000183327",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PRDA, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Gillette, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2026; 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.