NPIMap

Organization Active NPI

Wild for a Smile

  • Pediatric Dentistry
  • Greeley, CO
National Provider Identifier
1821162470
Registry record updated Sep 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
8526 Issued in CO
Legal business name
WILD FOR A SMILE
Practice address
1819 61St Avenue
Suite 101
Greeley, CO 80634-7986
Phone
(970) 506-1339
Fax
(970) 339-8500
NPI assigned
Nov 17, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2014

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

Authorized official

Name
Dr. Leah Mischelle Doll, DDSNPI 1780673541
Title
Pediatric Dentist
Phone
(970) 506-1339

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0221X 8526 CO Primary

Addresses

Primary practice location

1819 61St Avenue
Suite 101
Greeley, CO 80634-7986

Mailing address

1819 61St Avenue
Suite 101
Greeley, CO 80634-7986
Phone (970) 506-1339

National Provider Directory

National Provider Directory

Locations

1819 61st Ave
Ste 101
Greeley, CO 80634
Phone (970) 506-1339

Practitioners & affiliated clinicians

Practitioners 1

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": "1163721600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1411344000000",
    "number": "1821162470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1819 61ST AVENUE",
            "address_2": "SUITE 101",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "806347986",
            "telephone_number": "970-506-1339",
            "fax_number": "970-339-8500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1819 61ST AVENUE",
            "address_2": "SUITE 101",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "806347986",
            "telephone_number": "970-506-1339",
            "fax_number": "970-339-8500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILD FOR A SMILE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-17",
        "last_updated": "2014-09-22",
        "status": "A",
        "authorized_official_last_name": "DOLL",
        "authorized_official_first_name": "LEAH",
        "authorized_official_middle_name": "MISCHELLE",
        "authorized_official_title_or_position": "PEDIATRIC DENTIST",
        "authorized_official_telephone_number": "970-506-1339",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CO",
            "license": "8526",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greeley, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2014; 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.