Active NPI
Cassidy Jezlyn Bummer, DDS
- General Practice Dentistry
- Poplar, MT
National Provider Identifier
1558094813
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- DEN-DEN-LIC-23705
- Practice address
- 107 H Street E
Poplar, MT 59255 - Phone
- (406) 768-3491
- Fax
- (406) 768-3603
- NPI assigned
- Jul 5, 2022
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DEN-DEN-LIC-23705 | MT | Primary |
Addresses
Primary practice location
107 H Street E
Poplar, MT 59255
Mailing address
107 H St
Poplar, MT 59255-7817
Phone (406) 768-3491
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 |
|---|---|---|---|
| DEN-DEN-LIC-23705 | MT | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1656979200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1753747200000",
"number": "1558094813",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "107 H ST",
"city": "POPLAR",
"state": "MT",
"postal_code": "592557817",
"telephone_number": "406-768-3491",
"fax_number": "406-768-3603"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "107 H STREET E",
"city": "POPLAR",
"state": "MT",
"postal_code": "59255",
"telephone_number": "406-768-3491",
"fax_number": "406-768-3603"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUMMER",
"first_name": "CASSIDY",
"middle_name": "JEZLYN",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-07-05",
"last_updated": "2025-07-29",
"certification_date": "2025-07-29",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MT",
"license": "DEN-DEN-LIC-23705",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Poplar, MT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.