OrganizationActive
Pediatric Dentistry LLC
NPI 1265848774 · Pediatric Dentistry · Cheyenne, WY
Provider details
- NPI number
- 1265848774
- Entity type
- Organization
- Primary specialty
- Pediatric DentistryDental Providers
- Organization subpart
- No
- Authorized official
- Matthew Henry, Owner(307) 778-7100
Specialties & taxonomies
Dental Providers
Profile Score
Detailed profile(75/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
11 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
1439 Stillwater Ave Ste 7
Cheyenne, WY 82009-7367
Phone: (307) 778-7100
Fax: (307) 778-2824
Street-level locationGet directions
Mailing address
1439 Stillwater Ave Ste 7
Cheyenne, WY 82009-7367
Registry dates
- Enumerated
- 2014-07-03
- Last updated
- 2014-07-03
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.