Active NPI
Ilene Choal, D.D.S.
- General Practice Dentistry
- Gillette, WY
National Provider Identifier
1780035378
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 1443
- Practice address
- 417 W Flying Circle Dr
Gillette, WY 82716-4701 - Phone
- (307) 682-3353
- NPI assigned
- Jun 25, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 1443 | WY | Primary |
Addresses
Primary practice location
417 W Flying Circle Dr
Gillette, WY 82716-4701
Mailing address
417 W Flying Circle Dr
Gillette, WY 82716-4701
Phone (307) 682-3353
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1443 | WY | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1466812800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1466812800000",
"number": "1780035378",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "417 W FLYING CIRCLE DR",
"city": "GILLETTE",
"state": "WY",
"postal_code": "827164701",
"telephone_number": "307-682-3353"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "417 W FLYING CIRCLE DR",
"city": "GILLETTE",
"state": "WY",
"postal_code": "827164701",
"telephone_number": "307-682-3353"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHOAL",
"first_name": "ILENE",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-06-25",
"last_updated": "2016-06-25",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "WY",
"license": "1443",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gillette, WY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.