Meridian Dental Implants & Oral Surgery LLC

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

Legal business name

MERIDIAN DENTAL IMPLANTS & ORAL SURGERY LLC

Practice address

1443 Beck Ave
Cody, WY 82414-3730

Phone

(402) 805-4516

NPI assigned

Jul 15, 2026

Organization subpart

No

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

Authorized official

Name

Jenn Heritage

Title

Credentialing Manager

Phone

(402) 805-4516

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1784073600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1784073600000",
    "number": "1649199282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1443 BECK AVE",
            "city": "CODY",
            "state": "WY",
            "postal_code": "824143730",
            "telephone_number": "402-805-4516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1443 BECK AVE",
            "city": "CODY",
            "state": "WY",
            "postal_code": "824143730",
            "telephone_number": "402-805-4516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERIDIAN DENTAL IMPLANTS & ORAL SURGERY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-07-15",
        "last_updated": "2026-07-15",
        "certification_date": "2026-07-15",
        "status": "A",
        "authorized_official_last_name": "HERITAGE",
        "authorized_official_first_name": "JENN",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "402-805-4516"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deborah Datteri McMillan, OTR/L
• Karen M. Meador, PT
• Medical Center Pharmacy LLC
• Megan Fallon LCSW
• Pedro Alberto Mendoza, AGACNP
• Clint Earl Merritt, P.A.-C
• Ruth Ann Michels
• Isabella Mijares
• David Mills, MD
• Gail Ann Mills, PT

• Oral and Maxillofacial Surgery (Dentist) in Cody, WY
• Providers in Cody, WY by specialty
• Oral and Maxillofacial Surgery (Dentist) in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2026; 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.