Active NPI
Micah Daniel Himmerich, DDS
- General Practice Dentistry
- Diamondville, WY
National Provider Identifier
1790099489
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 1247
- Practice address
- 100 Canyon Road
Diamondville, WY 83116 - Phone
- (307) 877-6951
- NPI assigned
- Aug 5, 2010
- Last updated
- Aug 5, 2010
- Sex
- Male
- Sole proprietor
- Yes
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 | 1247 | WY | Primary |
Addresses
Primary practice location
100 Canyon Road
Diamondville, WY 83116
Mailing address
100 Canyon Road
PO Box 314
Diamondville, WY 83116
Phone (307) 877-6951
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 |
|---|---|---|---|
| 1247 | WY | MD | Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kemmerer Dental Inc | General Practice | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Kemmerer Dental Associates
- General Practice Dentistry
- Diamondville, WY
- NPI 1902946932
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1280966400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1280966400000",
"number": "1790099489",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 CANYON ROAD",
"address_2": "PO BOX 314",
"city": "DIAMONDVILLE",
"state": "WY",
"postal_code": "83116",
"telephone_number": "307-877-6951"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 CANYON ROAD",
"city": "DIAMONDVILLE",
"state": "WY",
"postal_code": "83116",
"telephone_number": "307-877-6951"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HIMMERICH",
"first_name": "MICAH",
"middle_name": "DANIEL",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-08-05",
"last_updated": "2010-08-05",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "WY",
"license": "1247",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Diamondville, WY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.