Organization Active NPI

Mathew D Schweppe

  • Pediatric Dentistry
  • South Ogden, UT
National Provider Identifier
1013261007
Registry record updated Oct 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
1432269923 Issued in UT
Legal business name
MATHEW D SCHWEPPE
Practice address
5685 S 1475 E Ste 3a
South Ogden, UT 84403-4598
Phone
(801) 479-9220
Fax
(801) 479-0837
NPI assigned
Oct 30, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2012

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

Authorized official

Name
Mathew Schweppe, DDSNPI 1215964234
Title
Owner
Phone
(801) 479-9220

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X 1432269923 UT Primary

Addresses

Primary practice location

5685 S 1475 E Ste 3a
South Ogden, UT 84403-4598

Mailing address

5685 S 1475 E
South Ogden, UT 84403-4716
Phone (801) 479-9220

Other identifiers 1

IdentifierTypeStateIssuer
517747532013MedicaidUT

National Provider Directory

National Provider Directory

Locations

5685 S 1475 E
South Ogden, UT 84403

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1351555200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1351555200000",
    "number": "1013261007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5685 S 1475 E",
            "city": "SOUTH OGDEN",
            "state": "UT",
            "postal_code": "844034716",
            "telephone_number": "801-479-9220",
            "fax_number": "801-479-8837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5685 S 1475 E STE 3A",
            "city": "SOUTH OGDEN",
            "state": "UT",
            "postal_code": "844034598",
            "telephone_number": "801-479-9220",
            "fax_number": "801-479-0837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MATHEW D SCHWEPPE",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-30",
        "last_updated": "2012-10-30",
        "status": "A",
        "authorized_official_last_name": "SCHWEPPE",
        "authorized_official_first_name": "MATHEW",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "801-479-9220",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "UT",
            "license": "1432269923",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "517747532013",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in South Ogden, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2012; 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.