DR. ROLAND BRANT GUSTAFSON DDS
NPI 1750437380
Dentist - Oral and Maxillofacial Surgery in Cheyenne, WY

Active since January 26, 2007Opted out of Medicare · through Feb 24, 2028
6238 YELLOWSTONE RD, CHEYENNE, WY 82009(307) 635-6940(307) 635-2839 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Dr. Roland Brant Gustafson Dds NPPES

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

DR. ROLAND BRANT GUSTAFSON DDS (NPI 1750437380) is an individual oral and maxillofacial surgery provider in Cheyenne, Wyoming, licensed in Wyoming (1054) and active in the NPI registry since January 2007. He has opted out of Medicare through February 24, 2028 and remains eligible to order and refer.

NPPES Registry Identity

NPI1750437380
Entity TypeIndividualMale
Primary Taxonomy1223S0112X
Provider Legal NameDR. ROLAND BRANT GUSTAFSONCredential: DDS
Location Address6238 YELLOWSTONE RDCheyenne, WY 82009-3432
Mailing Address6238 Yellowstone RdCheyenne, WY 82009-3432 · (307) 635-6940 · Fax (307) 635-2839
Fax(307) 635-2839
Sole ProprietorYes
Enumeration DateJanuary 26, 2007
Last NPPES UpdateJuly 8, 2007
NPI 1750437380 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyDentist · Oral and Maxillofacial SurgeryDental Providers
Taxonomy Code1223S0112X
License Licensed in WY · 1054
Definition

An oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.

6238 YELLOWSTONE RD, Cheyenne, WY 82009

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Opted out of Medicare

Dr. Roland Brant Gustafson Dds has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from February 24, 2016 through February 24, 2028.

Opt-Out Effective DateFebruary 24, 2016
Opt-Out In Effect ThroughFebruary 24, 2028Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 82009 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$87.12 typical visit price
range $56.42 – $170.72
Typical copayment $21.78 (range $14.10 – $42.68)
Most-billed visit code 99203
Established Patient
$70.32 typical visit price
range $18.19 – $139.32
Typical copayment $17.58 (range $4.54 – $34.83)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 4

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

Dentist (Oral and Maxillofacial Surgery)
6238 YELLOWSTONE RD
CHEYENNE, WY 82009
Clinic/Center (Oral and Maxillofacial Surgery)
6238 YELLOWSTONE RD
CHEYENNE, WY 82009
Dentist (Oral and Maxillofacial Surgery)
6238 YELLOWSTONE RD
CHEYENNE, WY 82009
Dentist (Oral and Maxillofacial Surgery)
6238 YELLOWSTONE RD
CHEYENNE, WY 82009

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 Roland Gustafson's NPI number?

The NPI number for Roland Gustafson is 1750437380. It was assigned to this individual provider in the NPPES registry on January 26, 2007.

Where is Roland Gustafson located?

Roland Gustafson practices at 6238 Yellowstone Rd, Cheyenne, WY 82009. The listed phone number is (307) 635-6940.

What is Roland Gustafson's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Surgery, with taxonomy code 1223S0112X.

Is Roland Gustafson enrolled in Medicare?

No. Roland Gustafson has opted out of Medicare through February 24, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

When was this NPI record last updated?

The NPPES record for Roland Gustafson was last updated on July 8, 2007. NPI Profile syncs with the weekly NPPES data releases published by CMS.