Active NPI
Moss Dentistry
- General Practice Dentistry
- Riverton, WY
National Provider Identifier
1962806331
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 1220
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 127527500 | Medicaid | WY |
National Provider Directory
National Provider Directory- Tax ID family
- Dental Care of Fremont County
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- General Practice Dentistry
- Riverton, WY
- NPI 1477792588
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- General Practice Dentistry
- Riverton, WY
- NPI 1942406079
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.