Bingham Endodontics, PLLC
Organization Active NPI Dental Clinic/Center · Jackson, WY
NPI 1972863207 · NPPES record last updated May 21, 2012
Key facts
- NPI
- 1972863207
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Dental Clinic/Center 261QD0000X
- License
- 1191 (WY)
- Legal business name
- BINGHAM ENDODONTICS, PLLC
- Practice address
- 610 W. Broadway Ave
Jackson, WY 83001 - Phone
- (208) 227-0382
- Fax
- (208) 227-0384
- NPI assigned
- May 21, 2012
- Organization subpart
- No
Authorized official
- Name
- Lynda Del Rio
- Title
- Office Manager
- Phone
- (208) 747-2651
Corporate family (same tax ID) 1
National Provider Directory
- Tax ID family
- Bingham Endodontics
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Clinic/Center | 261QD0000X | 1191 | WY | Yes |
Addresses
Primary practice location
610 W. Broadway Ave
Jackson, WY 83001
Mailing address
3387 Merlin Dr
Idaho Falls, ID 83404-7405
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780859223 | Medicaid | ID |
Other providers in Jackson, WY
- Hannah R Bernier
- Laura-Lee Berrett
- Kevin Bias
- Chandler Billingham
- Aaron Bilotta
- Biohealth Inc
- Trudylynn Birkemeyer Funk
- Kelly J Biscombe
- Kimberly Bjorkman
- Leah Black
All providers in Jackson, WY · Dental Clinic/Center in Wyoming
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 21, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.