Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1548678758 Individual Practitioner Male Practitioner

Grant Kollenborn

Dentist - General Practice • Jackson, WY

Professional Overview & Biography Verified Profile Summary

Grant Kollenborn is a registered healthcare professional specializing in Dentist - General Practice in Jackson, WY. Practice services are available at 1315 US-89, SUITE 102 under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

1315 Us-89, Suite 102

Jackson, WY 83001

Telephone 3077334122
Fax 3077334164
Associated Practice Facility / Clinic
🏢 Rebecca Cloetta Dds Pc Facility NPI 1629097282

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Jackson, WY

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 23.3 Yrs
Regional Practice Density
12 Specialists

Practicing in Jackson, WY (245 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2026-08-07
Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License LA 6488

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

1 Associated Practitioners
NPI 1306190749

Doctor of Dental Surgery

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

8 Historical Events
📍
Updated Practice Location August 07, 2026

Registered at 1315 US-89, SUITE 102, JACKSON, WY 83001 (Tel: 3077334122)

📍
Updated Business Mailing Address August 07, 2026

Registered at PO BOX 8888, JACKSON, WY 830028888 (Tel: 3076907377)

NPI Profile Active July 31, 2014

NPI status registered as active in NPPES database

📍
Updated Practice Location July 31, 2014

Registered at 5742 BANCROFT DR, NEW ORLEANS, LA 701221314 (Tel: 5042642151)

📍
Updated Business Mailing Address July 31, 2014

Registered at 5742 BANCROFT DR, NEW ORLEANS, LA 701221314 (Tel: 5042642151)

👤
Provider Name / Credentials Updated July 31, 2014

Recorded as GRANT KOLLENBORN

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 31, 2014

Dentist (License #6488 in LA)

🟢
Initial NPI Registration & Enumeration July 31, 2014

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1548678758
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: July 31, 2014
Last Update: August 07, 2026
Sole Proprietor: Yes

Mailing Address

Po Box 8888

Jackson, WY 830028888

Phone: 3076907377

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.