Wyoming Family Dental, PA

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D11362 Issued in MN

Legal business name

WYOMING FAMILY DENTAL, PA

Practice address

5305 E Viking Blvd
Wyoming, MN 55092-8014

Phone

(651) 462-5150

NPI assigned

May 10, 2007

Last updated

Jun 23, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Chad Loween, D.D.S.NPI 1194937821

Title

Co-Owner

Phone

(651) 462-5150

Specialties & licenses 1

Addresses

Tax ID family

Wyoming Family Dental2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Wyoming Family Dental

  • General Practice Dentistry
  • Wyoming, MN
  • NPI 1821696022
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Chad Edward Loween, D.D.S.

  • General Practice Dentistry
  • Wyoming, MN
  • NPI 1194937821
  NPD (past) Authorized official

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

{
    "created_epoch": "1178755200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214179200000",
    "number": "1720292402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4666 DALE ST N",
            "city": "SHOREVIEW",
            "state": "MN",
            "postal_code": "551266021",
            "telephone_number": "651-766-5771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5305 E VIKING BLVD",
            "city": "WYOMING",
            "state": "MN",
            "postal_code": "550928014",
            "telephone_number": "651-462-5150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WYOMING FAMILY DENTAL, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-10",
        "last_updated": "2008-06-23",
        "status": "A",
        "authorized_official_last_name": "LOWEEN",
        "authorized_official_first_name": "CHAD",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "651-462-5150",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D11362",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jaime Wirth, M.D.
• Ashley Renee Witek, PA-C
• Brooke M Witucki, OTD, OTR/L
• Wyoming Dental LLC
• Wyoming Family Dental
• Sherry Xiong, MS
• Kent N Yoshida, CRNA
• Saron Gebreab Zere, RN
• Yuriy Zgherea, M.D.
• Brianne Nicole Ziegler, CRNA

• General Practice Dentistry in Wyoming, MN
• Providers in Wyoming, MN by specialty
• General Practice Dentistry in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2008; 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.