Samuel C Davidson DDS LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

SAMUEL C DAVIDSON DDS LLC

Practice address

337 Greybull Ave
Greybull, WY 82426-2049

Phone

(307) 765-4654

Fax

(307) 333-0494

NPI assigned

Sep 1, 2023

Organization subpart

No

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

Authorized official

Name

Mrs. Ailina S Davidson

Title

Office Manager

Phone

(307) 272-1688

Specialties & licenses 1

Addresses

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Samuel Davidson, DDS

  • General Practice Dentistry
  • Greybull, WY
  • NPI 1861060444
  NPD
• Lance E. Anderson, DMD

  • General Practice Dentistry
  • Lovell, WY
  • NPI 1871857334
  NPD (past)
• Tate Ezra Anderson, DDS

  • General Practice Dentistry
  • Greybull, WY
  • NPI 1568023471
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1693526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693526400000",
    "number": "1841076288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "337 GREYBULL AVE",
            "city": "GREYBULL",
            "state": "WY",
            "postal_code": "824262049",
            "telephone_number": "307-765-4654",
            "fax_number": "307-333-0494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "337 GREYBULL AVE",
            "city": "GREYBULL",
            "state": "WY",
            "postal_code": "824262049",
            "telephone_number": "307-765-4654",
            "fax_number": "307-333-0494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAMUEL C DAVIDSON DDS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-01",
        "last_updated": "2023-09-01",
        "certification_date": "2023-09-01",
        "status": "A",
        "authorized_official_last_name": "DAVIDSON",
        "authorized_official_first_name": "AILINA",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "307-272-1688",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Heather Sanford, LPC
• Jeffrey Lee Scott, D.O.
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• Stephanie Kunkel Sloan
• Makyela Dawn Sorensen, PA-C

• General Practice Dentistry in Greybull, WY
• Providers in Greybull, WY by specialty
• General Practice Dentistry in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2023; 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.