Everett Maynard, D.D.S.

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

1343 Issued in WY

Practice address

295 N Walsh Dr
Casper, WY 82609-1911

Phone

(307) 265-7878

NPI assigned

Jul 1, 2013

Last updated

Jan 25, 2016By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: emaynard@yourcarecommunity.org

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.

• Denise R Prugh DDS

  dba Surfin Smiles

  • Pediatric Dentistry
  • Casper, WY
  • NPI 1679952865
  NPD (past)
• Surfin Smiles LLC

  • Pediatric Dentistry
  • Casper, WY
  • NPI 1205303195
  NPD (past)

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

{
    "created_epoch": "1372636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453680000000",
    "number": "1912347253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3361 E 18TH ST",
            "city": "CASPER",
            "state": "WY",
            "postal_code": "826093513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "295 N WALSH DR",
            "city": "CASPER",
            "state": "WY",
            "postal_code": "826091911",
            "telephone_number": "307-265-7878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYNARD",
        "first_name": "EVERETT",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-07-01",
        "last_updated": "2016-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NE",
            "license": "7089",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NE",
            "license": "7089",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "WY",
            "license": "1343",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Meenoo Mauldin, FNP-C
• William Burland Maurer, LCSW
• Margaret Maveety, PHARM.D.
• Ronald Andrew Maxwell, PHARM.D.
• Tiffani Renae May
• Brittany Mayo, MS, CCC-SLP
• Chelsea Mayo, LCSW
• Andrew D McAfee, M.D.
• Ashlynn Jade McAteer
• Charles E McBride, LPC

• Pediatric Dentistry in Casper, WY
• Providers in Casper, WY by specialty
• Pediatric Dentistry in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2016; 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.