NPIMap

Organization Active NPI

Wy Specialty Dental Services, LLC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Gillette, WY
National Provider Identifier
1346923133
Registry record updated Aug 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
Legal business name
WY SPECIALTY DENTAL SERVICES, LLC
Practice address
2670 Oakcrest Dr
Gillette, WY 82718-5905
Phone
(307) 257-8029
NPI assigned
Aug 9, 2023
Organization subpart
Yes
Parent organization
WY SPECIALTY DENTAL SERVICES, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 9, 2023

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

Authorized official

Name
Charlotte Dasch
Title
Director of Credentialing and PR
Phone
(504) 638-0303

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223X0400X Primary

Addresses

Primary practice location

2670 Oakcrest Dr
Gillette, WY 82718-5905

Mailing address

1610 54TH Ave N Ste 205
Nashville, TN 37209-1442
Phone (504) 638-0303

Other names 1

  • Cometti Orthodontics Former legal business name

National Provider Directory

National Provider Directory
Tax ID family
Wy Specialty Dental Services LLC3 organizations share this tax ID, including this one
Part of
Wy Specialty Dental Services LLC

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2670 Oakcrest Dr
Gillette, WY 82718
Phone (307) 257-8029

NPI Registry JSON

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

{
    "created_epoch": "1691539200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1691539200000",
    "number": "1346923133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1610 54TH AVE N STE 205",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372091442",
            "telephone_number": "504-638-0303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2670 OAKCREST DR",
            "city": "GILLETTE",
            "state": "WY",
            "postal_code": "827185905",
            "telephone_number": "307-257-8029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WY SPECIALTY DENTAL SERVICES, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WY SPECIALTY DENTAL SERVICES, LLC",
        "enumeration_date": "2023-08-09",
        "last_updated": "2023-08-09",
        "certification_date": "2023-08-09",
        "status": "A",
        "authorized_official_last_name": "DASCH",
        "authorized_official_first_name": "CHARLOTTE",
        "authorized_official_title_or_position": "DIRECTOR OF CREDENTIALING AND PR",
        "authorized_official_telephone_number": "504-638-0303"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cometti Orthodontics",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Cometti Orthodontics",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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 9, 2023; 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.