NPIMap

Organization Active NPI

Great Falls Pediatric Dentistry, LLC

  • Pediatric Dentistry
  • Great Falls, MT
National Provider Identifier
1922479047
Registry record updated Oct 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
2145 Issued in MT
Legal business name
GREAT FALLS PEDIATRIC DENTISTRY, LLC
Practice address
1717 4TH St S
Great Falls, MT 59405-4133
Phone
(406) 449-0189
Fax
(406) 449-7237
NPI assigned
Oct 15, 2015
Last updated
Oct 15, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2015

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

Authorized official

Name
Kevin L Rencher, D.D.S.NPI 1932296621
Title
Dentist
Phone
(406) 449-0189

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 2145 MT Primary

Addresses

Primary practice location

1717 4TH St S
Great Falls, MT 59405-4133

Mailing address

1717 4TH St S
Great Falls, MT 59405-4133
Phone (406) 449-0189

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1444867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1444867200000",
    "number": "1922479047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1717 4TH ST S",
            "city": "GREAT FALLS",
            "state": "MT",
            "postal_code": "594054133",
            "telephone_number": "406-449-0189",
            "fax_number": "406-449-7237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 4TH ST S",
            "city": "GREAT FALLS",
            "state": "MT",
            "postal_code": "594054133",
            "telephone_number": "406-449-0189",
            "fax_number": "406-449-7237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT FALLS PEDIATRIC DENTISTRY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-15",
        "last_updated": "2015-10-15",
        "status": "A",
        "authorized_official_last_name": "RENCHER",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "406-449-0189",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "MT",
            "license": "2145",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Great Falls, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2015; 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.