NPIMap

Organization Active NPI

Paintbrush Dental, PC

  • Dental Clinic/Center
  • Thermopolis, WY
National Provider Identifier
1982932265
Registry record updated Nov 25, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
1222 Issued in WY
Legal business name
PAINTBRUSH DENTAL, PC
Practice address
110 E Arapahoe St
Thermopolis, WY 82443
Phone
(307) 864-9411
Fax
(307) 864-2756
NPI assigned
Nov 25, 2009
Last updated
Nov 25, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2009

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

Authorized official

Name
Dr. Leif A PolsonNPI 1790737005
Title
Owner
Phone
(307) 864-9411

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X 1222 WY Primary

Addresses

Primary practice location

110 E Arapahoe St
Thermopolis, WY 82443

Mailing address

110 E Arapahoe St
PO Box 751
Thermopolis, WY 82440-0751
Phone (307) 864-9411

National Provider Directory

National Provider Directory

Locations

110 E Arapahoe St
Thermopolis, WY 82443
Phone (307) 864-9411

Practitioners & affiliated clinicians

Practitioners 3

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": "1259107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1259107200000",
    "number": "1982932265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 E ARAPAHOE ST",
            "address_2": "PO BOX 751",
            "city": "THERMOPOLIS",
            "state": "WY",
            "postal_code": "824400751",
            "telephone_number": "307-864-9411",
            "fax_number": "307-864-2756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 E ARAPAHOE ST",
            "city": "THERMOPOLIS",
            "state": "WY",
            "postal_code": "82443",
            "telephone_number": "307-864-9411",
            "fax_number": "307-864-2756"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAINTBRUSH DENTAL, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-25",
        "last_updated": "2009-11-25",
        "status": "A",
        "authorized_official_last_name": "POLSON",
        "authorized_official_first_name": "LEIF",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "307-864-9411",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "WY",
            "license": "1222",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Thermopolis, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2009; 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.