NPIMap

Organization Active NPI

Wyoming Family Dental

  • General Practice Dentistry
  • Wyoming, MN
National Provider Identifier
1821696022
Registry record updated Oct 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
WYOMING FAMILY DENTAL
Practice address
5378 East Viking Blvd.
Wyoming, MN 55092
Phone
(651) 462-5150
NPI assigned
Oct 12, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2020

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

Authorized official

Name
Jody Veugeler
Title
Officer Manager
Phone
(651) 462-5150

Specialties & licenses 1

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

Addresses

Primary practice location

5378 East Viking Blvd.
Wyoming, MN 55092

Mailing address

PO Box 189
Wyoming, MN 55092
Phone (651) 462-5150

National Provider Directory

National Provider Directory
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.

Locations

5378 E Viking Blvd
Wyoming, MN 55092
Phone (651) 462-5150

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": "1602460800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1602460800000",
    "number": "1821696022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 189",
            "city": "WYOMING",
            "state": "MN",
            "postal_code": "55092",
            "telephone_number": "651-462-5150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5378 EAST VIKING BLVD.",
            "city": "WYOMING",
            "state": "MN",
            "postal_code": "55092",
            "telephone_number": "651-462-5150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WYOMING FAMILY DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-12",
        "last_updated": "2020-10-12",
        "certification_date": "2020-10-07",
        "status": "A",
        "authorized_official_last_name": "VEUGELER",
        "authorized_official_first_name": "JODY",
        "authorized_official_title_or_position": "OFFICER MANAGER",
        "authorized_official_telephone_number": "651-462-5150"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wyoming, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2020; 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.