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ELKRIDGE DENTAL SOUTH LLC
NPI 1538822374
Clinic/Center - Dental in Jackson, WY

Active since October 19, 2021
1315 S HWY 89, JACKSON, WY 83001(307) 733-4122 Get Directions Write a Review

NPPES record last updated: October 19, 2021. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Elkridge Dental South Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ELKRIDGE DENTAL SOUTH LLC (NPI 1538822374) is a healthcare organization registered as a dental in Jackson, Wyoming and active in the NPI registry since October 2021. The organization lists Nathan Tanner, President, as its authorized official.

NPPES Registry Identity

NPI1538822374
Entity TypeOrganization
Primary Taxonomy261QD0000X
Legal Business NameELKRIDGE DENTAL SOUTH LLC
Location Address1315 S HWY 89Jackson, WY 83001-8514
Mailing AddressPo Box 1190Jackson, WY 83001-1190 · (307) 733-2555
Phone(307) 733-4122
Organization SubpartNo
Authorized OfficialNathan TannerPresident · (503) 866-8454
Enumeration DateOctober 19, 2021
NPPES CertifiedOctober 19, 2021
✔ NPI 1538822374 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · DentalAmbulatory Health Care Facilities
Taxonomy Code261QD0000X
1315 S HWY 89, Jackson, WY 83001
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Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SMILES 4 KIDS JACKSON LLC
Dentist (Pediatric Dentistry)
1315 S HWY 89, SUITE 102
JACKSON, WY 83001
Teton County (208) 716-9724
REBECCA CLOETTA DDS PC
Dentist
1315 S HWY 89, STE 102
JACKSON, WY 83001
Teton County (307) 733-4122

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Elkridge Dental South LLC's NPI number?

The NPI number for Elkridge Dental South LLC is 1538822374. It was assigned to this organization in the NPPES registry on October 19, 2021.

Where is Elkridge Dental South LLC located?

Elkridge Dental South LLC is located at 1315 S Hwy 89, Jackson, WY 83001. The listed phone number is (307) 733-4122.

What is Elkridge Dental South LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Dental, with taxonomy code 261QD0000X.

When was this NPI record last updated?

The NPPES record for Elkridge Dental South LLC was last updated on October 19, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.