NPIMap

Organization Active NPI

Bear River Dental

  • Dentist
  • Evanston, WY
National Provider Identifier
1649575465
Registry record updated Jan 26, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
1131 Issued in WY
Legal business name
BEAR RIVER DENTAL
Practice address
50 Park Rd
Evanston, WY 82930-2613
Phone
(307) 789-5608
Fax
(307) 789-4401
NPI assigned
Jan 26, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2011

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

Authorized official

Name
Nathan R Lester, DMDNPI 1558432120
Title
Owner
Phone
(307) 789-5608

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 1131 WY Primary
Oral and Maxillofacial Surgery (Dentist)Group: 193200000X MULTI-SPECIALTY GROUP 1223S0112X 1250 WY
Oral and Maxillofacial Surgery (Dentist)Group: 193200000X MULTI-SPECIALTY GROUP 1223S0112X 1257 WY
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223X0400X 1202 WY

Addresses

Primary practice location

50 Park Rd
Evanston, WY 82930-2613

Mailing address

50 Park Rd
Evanston, WY 82930-2613
Phone (307) 789-5608

Other identifiers 4

IdentifierTypeStateIssuer
1023268299MedicaidWY
1558432120MedicaidWY
1689795114MedicaidWY
1063492981MedicaidWY

Other names 1

  • Nathan R. Lester DMD PC Doing business as

National Provider Directory

National Provider Directory

Locations

50 Park Rd
Evanston, WY 82930
Phone (307) 789-5608

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1296000000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1296000000000",
    "number": "1649575465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 PARK RD",
            "city": "EVANSTON",
            "state": "WY",
            "postal_code": "829302613",
            "telephone_number": "307-789-5608",
            "fax_number": "307-789-4401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 PARK RD",
            "city": "EVANSTON",
            "state": "WY",
            "postal_code": "829302613",
            "telephone_number": "307-789-5608",
            "fax_number": "307-789-4401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEAR RIVER DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-26",
        "last_updated": "2011-01-26",
        "status": "A",
        "authorized_official_last_name": "LESTER",
        "authorized_official_first_name": "NATHAN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "307-789-5608",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "WY",
            "license": "1131",
            "primary": true
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "WY",
            "license": "1250",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "WY",
            "license": "1257",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "WY",
            "license": "1202",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1023268299",
            "state": "WY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1558432120",
            "state": "WY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1689795114",
            "state": "WY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1063492981",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Nathan R. Lester DMD PC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Evanston, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2011; 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.