Active NPI
Joel Grayson Sayre, D.M.D.
- Pediatric Dentistry
- Bozeman, MT
National Provider Identifier
1306922703
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 2212
- Practice address
- 115 W Kagy Blvd
Suite C
Bozeman, MT 59715-6027 - Phone
- (406) 587-2327
- Fax
- (406) 587-3338
- NPI assigned
- Oct 27, 2006
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 2212 | MT | Primary |
Addresses
Primary practice location
115 W Kagy Blvd
Suite C
Bozeman, MT 59715-6027
Mailing address
115 W Kagy Blvd
Suite C
Bozeman, MT 59715-6027
Phone (406) 587-2327
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0033319 | Other | MT | CHIP INS. WITH BCBS OF MT |
| 0033436 | Medicaid | MT |
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 |
|---|---|---|---|
| 2212 | MT | MD | Pediatric Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gallatin Valley Pediatric Dentistry | Pediatric Dentistry | Past | Accepting new patients |
| Wojj Pediatric Dentistry | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Pediatric Dentistry
- Bozeman, MT
- NPI 1750507703
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161907200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1306922703",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "115 W KAGY BLVD",
"address_2": "SUITE C",
"city": "BOZEMAN",
"state": "MT",
"postal_code": "597156027",
"telephone_number": "406-587-2327",
"fax_number": "406-587-3338"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "115 W KAGY BLVD",
"address_2": "SUITE C",
"city": "BOZEMAN",
"state": "MT",
"postal_code": "597156027",
"telephone_number": "406-587-2327",
"fax_number": "406-587-3338"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SAYRE",
"first_name": "JOEL",
"middle_name": "GRAYSON",
"credential": "D.M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-27",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "MT",
"license": "2212",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CHIP INS. WITH BCBS OF MT",
"identifier": "0033319",
"state": "MT"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0033436",
"state": "MT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bozeman, MT
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.