NPIMap

Organization Active NPI

Dixie Dental

  • General Practice Dentistry
  • St George, UT
National Provider Identifier
1003949827
Registry record updated Oct 8, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
6649422-9922 Issued in UT
Legal business name
DIXIE DENTAL
Doing business as
Dixie Dental
Practice address
425 E Tabernacle
St George, UT 84770
Phone
(435) 688-1400
Fax
(435) 688-1408
NPI assigned
Mar 13, 2007
Last updated
Oct 8, 2009By the provider in NPPES
Organization subpart
Yes
Parent organization
DIXIE DENTALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 8, 2009

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

Authorized official

Name
Brandon D. Henderson, DMD, PCNPI 1821296484
Title
Dentist D.D.S.
Phone
(435) 688-1400

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X 983604379922 UT
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X 6649422-9922 UT Primary

Addresses

Primary practice location

425 E Tabernacle
St George, UT 84770

Mailing address

425 East Tabernacle
St. George, UT 84770
Phone (435) 688-1400

Other names 1

  • Dixie Dental Doing business as

National Provider Directory

National Provider Directory
Part of
Dixie Dental

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1254960000000",
    "number": "1003949827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 EAST TABERNACLE",
            "city": "ST. GEORGE",
            "state": "UT",
            "postal_code": "84770",
            "telephone_number": "435-688-1400",
            "fax_number": "435-688-1408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 E TABERNACLE",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "84770",
            "telephone_number": "435-688-1400",
            "fax_number": "435-688-1408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIXIE DENTAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DIXIE DENTAL",
        "enumeration_date": "2007-03-13",
        "last_updated": "2009-10-08",
        "status": "A",
        "authorized_official_last_name": "HENDERSON",
        "authorized_official_first_name": "BRANDON",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "DENTIST D.D.S.",
        "authorized_official_telephone_number": "435-688-1400",
        "authorized_official_credential": "DMD, PC"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "UT",
            "license": "983604379922",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "UT",
            "license": "6649422-9922",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dixie Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in St George, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2009; 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.