Elk Ridge Dental

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

1083 Issued in WY

Legal business name

ELK RIDGE DENTAL

Practice address

200 East Broadway
Jackson, WY 83001

Phone

(307) 733-2555

Fax

(307) 733-2552

NPI assigned

Oct 13, 2006

Organization subpart

No

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

Authorized official

Name

Aaron Galbraith, D.M.D

Title

Owner

Phone

(307) 733-2555

Specialties & licenses 1

Addresses

Other names 1

• ElkRidge Dental Doing business as

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

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1497845127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1190",
            "city": "JACKSON",
            "state": "WY",
            "postal_code": "830011190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 EAST BROADWAY",
            "city": "JACKSON",
            "state": "WY",
            "postal_code": "83001",
            "telephone_number": "307-733-2555",
            "fax_number": "307-733-2552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELK RIDGE DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GALBRAITH",
        "authorized_official_first_name": "AARON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "307-733-2555",
        "authorized_official_credential": "D.M.D"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "WY",
            "license": "1083",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ElkRidge Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Leann M. Dzemske, M. SC., LPC, ATR
• Molly Katherine Eagar, RN
• East Jackson Mental Health
• Jessica B Eastman, MS, OTR/L
• Anna Sigrid Eide, RD
• Elkridge Dental South LLC
• Samantha Elkrief, LCSW
• Julie Elledge, LMFT182
• Ellen Nolan, Aprn, PC
• Anne Ellingson, PROVISIONAL

• General Practice Dentistry in Jackson, WY
• Providers in Jackson, WY by specialty
• General Practice Dentistry in Wyoming

• 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.