Individual provider Active NPI

Gary Anthony Carter, D.D.S., M.S.

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • West Valley City, UT
National Provider Identifier
1003812116
Registry record updated Oct 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
335041-9921 Issued in UT
Practice address
4645 S 4000 W Ste B
West Valley City, UT 84120-6250
Phone
(801) 955-1900
NPI assigned
Jun 23, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 335041-9921 UT Primary

Addresses

Primary practice location

4645 S 4000 W Ste B
West Valley City, UT 84120-6250

Mailing address

12207 S Wigwam LN
Draper, UT 84020-8855
Phone (385) 445-1777

Other practice location 1

10011 Centennial Pkwy
Ste 240
Sandy, UT 84070-4156
Phone (801) 255-9000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
335041-9921UTMDOrthodontics and Dentofacial Orthopedic Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Modern Dental Professionals - Utah, PC CurrentSince Oct 13, 2024 Accepting new patients
Gary a Carter, D.D.S., M.S., PC PastSince Aug 6, 2023 Accepting new patients

Locations

4645 S 4000 W
Ste B
West Valley City, UT 84120
Phone (216) 264-6804

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1119484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728604800000",
    "number": "1003812116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12207 S WIGWAM LN",
            "city": "DRAPER",
            "state": "UT",
            "postal_code": "840208855",
            "telephone_number": "385-445-1777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4645 S 4000 W STE B",
            "city": "WEST VALLEY CITY",
            "state": "UT",
            "postal_code": "841206250",
            "telephone_number": "801-955-1900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10011 Centennial Pkwy",
            "address_2": "Ste 240",
            "address_purpose": "LOCATION",
            "city": "Sandy",
            "state": "UT",
            "postal_code": "840704156",
            "country_code": "US",
            "telephone_number": "801-255-9000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARTER",
        "first_name": "GARY",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "D.D.S., M.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-23",
        "last_updated": "2024-10-11",
        "certification_date": "2024-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "UT",
            "license": "335041-9921",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Valley City, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.