NPIMap

Individual provider Active NPI

Matthew Gary Wold, DMD

  • Pediatric Dentistry
  • Casper, WY
National Provider Identifier
1891218392
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
1484 Issued in WY
Practice address
5040 E 2ND St Ste 2
Casper, WY 82609-4468
Phone
(307) 462-3752
Fax
(307) 337-4929
NPI assigned
Jul 18, 2017
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 1484 WY Primary

Addresses

Primary practice location

5040 E 2ND St Ste 2
Casper, WY 82609-4468

Mailing address

5040 E 2ND St Ste 2
Casper, WY 82609-4468
Phone (307) 462-3752

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

Practice roles

OrganizationSpecialtyStatusNew patients
City of Casper-Natrona County Health Department Current Accepting new patients
City of Casper-Natrona County Health Department Single Specialty Current Accepting new patients
Children's Dentistry LLC Pediatric Dentistry Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: mwold@yourcarecommunity.org

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1500336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1891218392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5040 E 2ND ST STE 2",
            "city": "CASPER",
            "state": "WY",
            "postal_code": "826094468",
            "telephone_number": "307-462-3752",
            "fax_number": "307-337-4929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5040 E 2ND ST STE 2",
            "city": "CASPER",
            "state": "WY",
            "postal_code": "826094468",
            "telephone_number": "307-462-3752",
            "fax_number": "307-337-4929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLD",
        "first_name": "MATTHEW",
        "middle_name": "GARY",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-07-18",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "WY",
            "license": "1484",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Casper, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.