DENISE R PRUGH DDS (NPI# 1679952865) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679952865 |
| Entity Type | Organization |
| Organization Name | DENISE R PRUGH DDS |
| Other Organization Name | SURFIN SMILES |
| Practice Address |
295 N Walsh Dr Casper WY 82609-1911 |
| Practice Telephone | 3072657878 |
| Practice Fax Number | 3072684953 |
| Mailing Telephone | 3072657878 |
| Enumeration Date | 2015-05-21 |
| Last Update Date | 2015-05-21 |
| Authorized Official Name | DENISE ROBIN PRUGH (OWNER) |
| Authorized Official Telephone | 3072657878 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1223X0400X |
Dentist Specialization: Orthodontics and Dentofacial Orthopedics |
Dental Providers | ||
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WY | 114491000 | 05 |
| Other Name | Type Code |
|---|---|
| Surfin Smiles | Doing Business As Name - Organization |
| Street Address |
295 N WALSH DR |
| City | CASPER |
| State | WY |
| Zip Code | 82609-1911 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003921735 | Denise R Prugh | Dentist | 295 N Walsh Dr, Casper, WY 82609-1911 | 2006-08-21 |
| 1205303195 | Surfin Smiles LLC | Dentist | 295 N Walsh Dr, Casper, WY 82609-1911 | 2018-10-29 |
| 1912347253 | Everett Maynard | Dentist | 295 N Walsh Dr, Casper, WY 82609-1911 | 2013-07-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265047773 | Backcountry Dox, LLC | Family Medicine | 1320 Morado Dr, Casper, WY 82609 | 2020-09-11 |
| 1174158273 | Harmony Case Management LLC | Case Management | 219 S Sinclair Pl, Casper, WY 82609 | 2020-03-09 |
| 1427417815 | Haley Perl | Speech-Language Pathologist | 2510 E 15th St Ste 15, Casper, WY 82609 | 2016-02-15 |
| 1538550496 | Andrea Renee Swanson | Counselor | 2015 E. 15th St., Suite 10, Casper, WY 82609 | 2015-02-13 |
| 1619386901 | Kmart Pharmacy | Pharmacy | 4000 East 2nd, Casper, WY 82609 | 2014-08-12 |
| 1306268628 | Kati Jo Tuma | Physician Assistant | 6600 E. 2nd Street, Casper, WY 82609 | 2014-01-07 |
| 1609297506 | Summit Medical Center, LLC | General Acute Care Hospital | 6350 E. 2nd Street, Casper, WY 82609 | 2013-12-18 |
| 1013354158 | Phillip Hermon | Registered Nurse | 2515 East 8th St, Casper, WY 82609 | 2013-05-30 |
| 1992141527 | Wind City Dental | Dentist | 1530 Centennial Court, Casper, WY 82609 | 2013-05-22 |
| 1235404930 | Melanie Anne Connell | Counselor | 2955 E. 2nd St., Casper, WY 82609 | 2012-03-13 |
| Find all providers in zip 82609 | ||||
| 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 |
|---|---|---|---|---|
| 1891218392 | Matthew Gary Wold | Dentist | 5040 E 2nd St Ste 2, Casper, WY 82609-4468 | 2017-07-18 |
| 1750584173 | Roy E. Paulson Jr PC | Dentist | 102 N. Kenwood St., Casper, WY 82601-2724 | 2007-06-06 |
| 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 |
| 1205303195 | Surfin Smiles LLC | Dentist | 295 N Walsh Dr, Casper, WY 82609-1911 | 2018-10-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942775960 | Clubhouse Pediatric Dentistry of Jackson | Dentist | 1130 Us-89, Jackson Hole, WY 83001-8701 | 2018-10-05 |
| 1013289966 | Gillette Pediatric Dentistry LLC | Dentist | 433 Shadow Ridge Blvd, Sheridan, WY 82801-9350 | 2012-02-07 |
| 1477862076 | David G Bailey | Dentist | 531 Coffeen Ave, Sheridan, WY 82801-5311 | 2010-09-29 |
| 1972822930 | Abc Pediatric Dentistry, LLC | Dentist | 610 S 4j Ct # B, Gillette, WY 82716-4127 | 2010-05-28 |
| 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 |
| 1477571610 | John Reichmann Leonard | Dentist | 1439 Stillwater Ave Ste 7, Cheyenne, WY 82009-7367 | 2006-07-17 |
| 1619434313 | Childrens Dental Center of Rock Springs | Dentist | 1208 Hilltop Dr Ste 209, Rock Springs, WY 82901-5860 | 2019-02-28 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on DENISE R PRUGH DDS.
| 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.