ABC PEDIATRIC DENTISTRY, LLC (NPI# 1972822930) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972822930 |
| Entity Type | Organization |
| Organization Name | ABC PEDIATRIC DENTISTRY, LLC |
| Practice Address |
610 S 4j Ct # B Gillette WY 82716-4127 |
| Mailing Address |
4019 W 12600 S Ste 200 Riverton UT 84096-7406 |
| Practice Telephone | 8018426971 |
| Mailing Telephone | 8018426971 |
| Enumeration Date | 2010-05-28 |
| Last Update Date | 2010-05-28 |
| Authorized Official Name | DR. NATHAN D STEVENSON (MANAGER) |
| Authorized Official Telephone | 8018426971 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
Dental Providers |
| Street Address |
610 S 4J CT # B |
| City | GILLETTE |
| State | WY |
| Zip Code | 82716-4127 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053822387 | Diana Lynn Ohman | Dietitian, Registered | 709 West Eighth Street, Suite 4, Gillette, WY 82716 | 2017-10-13 |
| 1821457821 | Courage To Change Counseling LLC | Community/Behavioral Health | 113 S. Gillette Ave, Gillette, WY 82716 | 2016-02-18 |
| 1003290594 | Kris Huber | Community/Behavioral Health | 905 Gurley Ave, Gillette, WY 82716 | 2015-07-14 |
| 1649516857 | Shirley L Haley | Nurse Practitioner | 1304 West 4th Street, Gillette, WY 82716 | 2012-12-14 |
| 1174867188 | Rebecca J Mader | Registered Nurse | 501 South Burma Ave., Gillette, WY 82716 | 2012-11-15 |
| 1568728228 | Kerry Elizabeth Warner | Registered Nurse | 201 S Burma Ave, Gillette, WY 82716 | 2012-04-07 |
| 1720363351 | Julie Ann Faldalen | Licensed Practical Nurse | 501 South Burma, Gillette, WY 82716 | 2011-10-14 |
| 1083937486 | Clear Creek Counseling LLC | Counselor | 801 E. 4th St., Suite 24, Gillette, WY 82716 | 2010-03-12 |
| 1821241423 | Dianna L Knox | Counselor | 500 S Burma Ave, Gillette, WY 82716 | 2008-10-28 |
| 1588826887 | Scott R Hunter | Chiropractor | 439 Prairie View Place Ste D, Dr S R Hunter, Gillette, WY 82716 | 2008-06-27 |
| Find all providers in zip 82716 | ||||
| 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 |
|---|---|---|---|---|
| 1821207036 | Roy E. Paulson Jr PC | Dentist | 2805 Cedar Ave Ste A, Gillette, WY 82718-2000 | 2007-05-22 |
| 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 |
| 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 |
| 1750584173 | Roy E. Paulson Jr PC | Dentist | 102 N. Kenwood St., Casper, WY 82601-2724 | 2007-06-06 |
| 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.