NPIMap

Organization Active NPI

Denise R Prugh DDS

  • Pediatric Dentistry
  • Casper, WY
National Provider Identifier
1679952865
Registry record updated May 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
Legal business name
DENISE R PRUGH DDS
Practice address
295 N Walsh Dr
Casper, WY 82609-1911
Phone
(307) 265-7878
Fax
(307) 268-4953
NPI assigned
May 21, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 21, 2015

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

Authorized official

Name
Denise Robin Prugh, DDSNPI 1003921735
Title
Owner
Phone
(307) 265-7878

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0221X Primary
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223X0400X

Addresses

Primary practice location

295 N Walsh Dr
Casper, WY 82609-1911

Mailing address

295 N Walsh Dr
Casper, WY 82609-1911
Phone (307) 265-7878

Other identifiers 1

IdentifierTypeStateIssuer
114491000MedicaidWY

Other names 1

  • Surfin Smiles Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1432166400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1432166400000",
    "number": "1679952865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "295 N WALSH DR",
            "city": "CASPER",
            "state": "WY",
            "postal_code": "826091911",
            "telephone_number": "307-265-7878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "295 N WALSH DR",
            "city": "CASPER",
            "state": "WY",
            "postal_code": "826091911",
            "telephone_number": "307-265-7878",
            "fax_number": "307-268-4953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENISE R PRUGH DDS",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-21",
        "last_updated": "2015-05-21",
        "status": "A",
        "authorized_official_last_name": "PRUGH",
        "authorized_official_first_name": "DENISE",
        "authorized_official_middle_name": "ROBIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "307-265-7878",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "114491000",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Surfin Smiles",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Casper, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2015; 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.