NPIMap

Organization Active NPI

Kincheloe Dental Office, PC

  • General Practice Dentistry
  • Cheyenne, WY
National Provider Identifier
1881711174
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
1070 Issued in WY
Legal business name
KINCHELOE DENTAL OFFICE, PC
Practice address
6244 Yellowstone Rd
Cheyenne, WY 82009-3432
Phone
(307) 638-8520
NPI assigned
Mar 23, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Bradley B Kincheloe, DDSNPI 1194842492
Title
Officer
Phone
(307) 638-8520

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
General Practice Dentistry 1223G0001X 1070 WY Primary

Addresses

Primary practice location

6244 Yellowstone Rd
Cheyenne, WY 82009-3432

Mailing address

2625 Wildhorse TRL
Cheyenne, WY 82009-2232
Phone (307) 638-6544

National Provider Directory

National Provider Directory

Locations

6244 Yellowstone Rd
Cheyenne, WY 82009
Phone (307) 638-8520

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1174608000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1881711174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2625 WILDHORSE TRL",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820092232",
            "telephone_number": "307-638-6544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6244 YELLOWSTONE RD",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820093432",
            "telephone_number": "307-638-8520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KINCHELOE DENTAL OFFICE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KINCHELOE",
        "authorized_official_first_name": "BRADLEY",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OFFICER",
        "authorized_official_telephone_number": "307-638-8520",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WY",
            "license": "1070",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cheyenne, WY

Sources for this page

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