NPIMap

Organization Active NPI

Aspen Hills Dental LLC

Doing business as Livingston Dental

  • Dentist
  • Afton, WY
National Provider Identifier
1417351602
Registry record updated Apr 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
910 Issued in WY
Legal business name
ASPEN HILLS DENTAL LLC
Doing business as
Livingston Dental
Practice address
800 South Washington St.
Afton, WY 83110
Phone
(307) 885-4337
Fax
(307) 885-4334
NPI assigned
Oct 16, 2014
Last updated
Apr 6, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2017

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

Authorized official

Name
Jeanelle Elmoyne Livingston, RN
Title
Operations Leader
Phone
(307) 885-4337

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 910 WY Primary

Addresses

Primary practice location

800 South Washington St.
Afton, WY 83110

Mailing address

800 South Washington St.
800 South Washington
Afton, WY 83110
Phone (307) 885-4337

Other identifiers 1

IdentifierTypeStateIssuer
112487100MedicaidWY

Other names 1

  • Livingston Dental Doing business as

National Provider Directory

National Provider Directory

Locations

800 S Washington St
Afton, WY 83110
Phone (307) 885-4337

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1413417600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1491436800000",
    "number": "1417351602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 SOUTH WASHINGTON ST.",
            "address_2": "800 SOUTH WASHINGTON",
            "city": "AFTON",
            "state": "WY",
            "postal_code": "83110",
            "telephone_number": "307-885-4337",
            "fax_number": "307-885-4334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 SOUTH WASHINGTON ST.",
            "city": "AFTON",
            "state": "WY",
            "postal_code": "83110",
            "telephone_number": "307-885-4337",
            "fax_number": "307-885-4334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASPEN HILLS DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-16",
        "last_updated": "2017-04-06",
        "status": "A",
        "authorized_official_last_name": "LIVINGSTON",
        "authorized_official_first_name": "JEANELLE",
        "authorized_official_middle_name": "ELMOYNE",
        "authorized_official_title_or_position": "OPERATIONS LEADER",
        "authorized_official_telephone_number": "307-885-4337",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WY",
            "license": "910",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "112487100",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Livingston Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Afton, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2017; 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.