Individual provider Active NPI

Michael Glenn Bingham, DMD

  • Pediatric Dentistry
  • Billings, MT
National Provider Identifier
1609896851
Registry record updated Aug 31, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
D1177 Issued in SD
Practice address
4538 Swan LN
Billings, MT 59106-4707
Phone
(208) 851-1679
NPI assigned
Jul 20, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 31, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X D-3996 ID
Pediatric Dentistry 1223P0221X 1308 WY
Pediatric Dentistry 1223P0221X D1177 SD Primary

Addresses

Primary practice location

4538 Swan LN
Billings, MT 59106-4707

Mailing address

4538 Swan LN
Billings, MT 59106-4707
Phone (208) 851-1679

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

LicenseStateTypeSpecialty
D-3996IDMDDentist
D1177SDMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Children'S Dentistry LLC Pediatric Dentistry PastSince Jul 25, 2021 Accepting new patients
Children'S Dentistry LLC Pediatric Dentistry Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598832000000",
    "number": "1609896851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4538 SWAN LN",
            "city": "BILLINGS",
            "state": "MT",
            "postal_code": "591064707",
            "telephone_number": "208-851-1679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4538 SWAN LN",
            "city": "BILLINGS",
            "state": "MT",
            "postal_code": "591064707",
            "telephone_number": "208-851-1679"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BINGHAM",
        "first_name": "MICHAEL",
        "middle_name": "GLENN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-20",
        "last_updated": "2020-08-31",
        "certification_date": "2020-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "ID",
            "license": "D-3996",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "WY",
            "license": "1308",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "SD",
            "license": "D1177",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Billings, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 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.