GILLETTE PEDIATRIC DENTISTRY LLC (NPI# 1013289966) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013289966 |
| Entity Type | Organization |
| Organization Name | GILLETTE PEDIATRIC DENTISTRY LLC |
| Practice Address |
433 Shadow Ridge Blvd Sheridan WY 82801-9350 |
| Mailing Address |
530 Running W Drive Suite 100 Gillette WY 82718-2003 |
| Practice Telephone | 3076708118 |
| Mailing Telephone | 3076708118 |
| Enumeration Date | 2012-02-07 |
| Last Update Date | 2017-01-06 |
| Authorized Official Name | DR. DAVID GLENN BAILEY (PEDIATRIC DENTIST) |
| Authorized Official Telephone | 3076708118 |
| Authorized Official Credential | D.D.S. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
1271 | WY | Dental Providers |
| Street Address |
433 SHADOW RIDGE BLVD |
| City | SHERIDAN |
| State | WY |
| Zip Code | 82801-9350 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891320172 | Sarah Coulter | Physician Assistant | 1401 W 5th Street, Attention Medical Services Staff, Sheridan, WY 82801 | 2020-03-07 |
| 1013552082 | Bonnie Bowman Schlesselman | Occupational Therapy Assistant | 1851 Big Horn Ave Sheridan Manor, Sheridan, WY 82801 | 2019-11-13 |
| 1790320976 | Jory Lee Turk | Physical Therapy Assistant | 1851 Bighorn Ave Sheridan Manor, Sheridan, WY 82801 | 2019-11-12 |
| 1356901532 | Kelsi Marie Martinez | Speech-Language Pathologist | 376 W Brundage St, Sheridan, WY 82801 | 2019-06-19 |
| 1841760410 | Christopher Michael Evans | Peer Specialist | 1221 W 5th Street, Sheridan, WY 82801 | 2018-11-27 |
| 1922582402 | Wyoming Eye Surgeons | Ophthalmology | 36 N. Gould St., Suite 2a, Sheridan, WY 82801 | 2018-09-20 |
| 1700368164 | Ashly Rose Garretson | Case Manager/Care Coordinator | 616 W 10th, Sheridan, WY 82801 | 2018-09-02 |
| 1053805382 | Sheridan Peak Wellness | Nutritionist | 740 S. Thurmond St., Sheridan, WY 82801 | 2018-06-20 |
| 1275040636 | Amber Van Dyke | Case Management | 757 Hwy 14 E, Sheridan, WY 82801 | 2018-01-08 |
| 1689103046 | Laura L Burrell | Case Manager/Care Coordinator | 151 W Brundage Street, Sheridan, WY 82801 | 2017-06-08 |
| Find all providers in zip 82801 | ||||
| Taxonomy Code | 1223P0221X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Pediatric Dentistry |
| An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477862076 | David G Bailey | Dentist | 531 Coffeen Ave, Sheridan, WY 82801-5311 | 2010-09-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942775960 | Clubhouse Pediatric Dentistry of Jackson | Dentist | 1130 Us-89, Jackson Hole, WY 83001-8701 | 2018-10-05 |
| 1891218392 | Matthew Gary Wold | Dentist | 5040 E 2nd St Ste 2, Casper, WY 82609-4468 | 2017-07-18 |
| 1972822930 | Abc Pediatric Dentistry, LLC | Dentist | 610 S 4j Ct # B, Gillette, WY 82716-4127 | 2010-05-28 |
| 1750584173 | Roy E. Paulson Jr PC | Dentist | 102 N. Kenwood St., Casper, WY 82601-2724 | 2007-06-06 |
| 1821207036 | Roy E. Paulson Jr PC | Dentist | 2805 Cedar Ave Ste A, Gillette, WY 82718-2000 | 2007-05-22 |
| 1518091859 | Jay Q. Cole | Dentist | 6900 Yellowtail Rd, Suite 100, Cheyenne, WY 82009-6102 | 2007-03-16 |
| 1760520514 | L Grant Christensen | Dentist | 657 Pilot Butte Ave, Rock Springs, WY 82901-5343 | 2007-02-02 |
| 1750459319 | David A Krise | Dentist | 25 Pebbles Lane, Lander, WY 82520 | 2006-12-01 |
| 1104921907 | Roy E Paulson | Dentist | 102 N Kenwood, Casper, WY 82601 | 2006-09-14 |
| 1003921735 | Denise R Prugh | Dentist | 295 N Walsh Dr, Casper, WY 82609-1911 | 2006-08-21 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.