NPIMap

Organization Active NPI

Riverton Smiles

  • General Practice Dentistry
  • Riverton, WY
National Provider Identifier
1770860595
Registry record updated Nov 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
1093 Issued in WY
Legal business name
RIVERTON SMILES
Practice address
1224 East Jackson Ave
Riverton, WY 82501-3841
Phone
(307) 856-3463
Fax
(307) 856-9910
NPI assigned
Nov 8, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2011

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

Authorized official

Name
Dr. Joshua G Wagner, D.D.S
Title
Dentist
Phone
(307) 856-3463

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 1093 WY Primary

Addresses

Primary practice location

1224 East Jackson Ave
Riverton, WY 82501-3841

Mailing address

1224 E Jackson Ave
Riverton, WY 82501-3841
Phone (307) 856-3463

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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": "1320710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1320710400000",
    "number": "1770860595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1224 E JACKSON AVE",
            "city": "RIVERTON",
            "state": "WY",
            "postal_code": "825013841",
            "telephone_number": "307-856-3463",
            "fax_number": "307-856-9910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1224 EAST JACKSON AVE",
            "city": "RIVERTON",
            "state": "WY",
            "postal_code": "825013841",
            "telephone_number": "307-856-3463",
            "fax_number": "307-856-9910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVERTON SMILES",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-08",
        "last_updated": "2011-11-08",
        "status": "A",
        "authorized_official_last_name": "WAGNER",
        "authorized_official_first_name": "JOSHUA",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "307-856-3463",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "WY",
            "license": "1093",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverton, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 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.