Organization Active NPI

Moss Dentistry

  • General Practice Dentistry
  • Riverton, WY
National Provider Identifier
1962806331
Registry record updated Oct 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
1220 Issued in WY
Legal business name
MOSS DENTISTRY
Practice address
203 E Main Street, Suite 205
Riverton, WY 82501
Phone
(307) 857-2020
Fax
(307) 857-2727
NPI assigned
Oct 14, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2014

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

Authorized official

Name
Mrs. Shelley J Griffin
Title
Office Manager
Phone
(307) 857-2020

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 1220 WY Primary

Addresses

Primary practice location

203 E Main Street, Suite 205
Riverton, WY 82501

Mailing address

203 E Main Street, Suite 205
Riverton, WY 82501
Phone (307) 857-2020

Other identifiers 1

IdentifierTypeStateIssuer
127527500MedicaidWY

National Provider Directory

National Provider Directory
Tax ID family
Dental Care of Fremont County2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the 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.

NPI Registry JSON

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

{
    "created_epoch": "1413244800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1413244800000",
    "number": "1962806331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 E MAIN STREET, SUITE 205",
            "city": "RIVERTON",
            "state": "WY",
            "postal_code": "82501",
            "telephone_number": "307-857-2020",
            "fax_number": "307-857-2727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 E MAIN STREET, SUITE 205",
            "city": "RIVERTON",
            "state": "WY",
            "postal_code": "82501",
            "telephone_number": "307-857-2020",
            "fax_number": "307-857-2727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOSS DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-14",
        "last_updated": "2014-10-14",
        "status": "A",
        "authorized_official_last_name": "GRIFFIN",
        "authorized_official_first_name": "SHELLEY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "307-857-2020",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "WY",
            "license": "1220",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "127527500",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverton, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2014; 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.