NPIMap

Organization Active NPI

Aesthetic Dentistry PC

  • General Practice Dentistry
  • Cheyenne, WY
National Provider Identifier
1487635926
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
WY963 Issued in WY
Legal business name
AESTHETIC DENTISTRY PC
Practice address
2029 Bluegrass Cir
Cheyenne, WY 82009-7368
Phone
(307) 632-6597
Fax
(307) 632-2170
NPI assigned
Nov 10, 2005
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Mary Kay Krivy, DDSNPI 1568440519
Title
DDS Dentist
Phone
(307) 632-6597

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X WY963 WY Primary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X WY967 WY

Addresses

Primary practice location

2029 Bluegrass Cir
Cheyenne, WY 82009-7368

Mailing address

2029 Bluegrass Cir
Cheyenne, WY 82009-7368
Phone (307) 632-6597

Other names 1

  • Eric A Dziurdziel DDS & Mary Kay Krivy DDS PC Former legal business name

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1131580800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1487635926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2029 BLUEGRASS CIR",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820097368",
            "telephone_number": "307-632-6597",
            "fax_number": "307-632-2170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2029 BLUEGRASS CIR",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820097368",
            "telephone_number": "307-632-6597",
            "fax_number": "307-632-2170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AESTHETIC DENTISTRY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KRIVY",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "KAY",
        "authorized_official_title_or_position": "DDS DENTIST",
        "authorized_official_telephone_number": "307-632-6597",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "WY",
            "license": "WY963",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "WY",
            "license": "WY967",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eric A Dziurdziel DDS & Mary Kay Krivy DDS PC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Cheyenne, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.