NPIMap

Organization Active NPI

City Creek Dental, PLLC

  • Dental Clinic/Center
  • Salt Lake City, UT
National Provider Identifier
1013367036
Registry record updated Jun 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
5673900 Issued in UT
Legal business name
CITY CREEK DENTAL, PLLC
Practice address
175 S West Temple Ste 100
Salt Lake City, UT 84101-1443
Phone
(801) 364-7943
Fax
(801) 364-3373
NPI assigned
Jun 21, 2016
Last updated
Jun 21, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2016

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

Authorized official

Name
Walter Landon Bye, DDSNPI 1689713497
Title
Owner/Partner
Phone
(801) 364-7943

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X 5673900 UT Primary
Dental Clinic/Center 261QD0000X 7991108 UT

Addresses

Primary practice location

175 S West Temple Ste 100
Salt Lake City, UT 84101-1443

Mailing address

175 S West Temple Ste 100
Salt Lake City, UT 84101-1443
Phone (801) 364-7943

National Provider Directory

National Provider Directory

Locations

175 S West Temple
Ste 100
Salt Lake City, UT 84101
Phone (801) 364-7943

Practitioners & affiliated clinicians

Practitioners 1

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": "1466467200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1466467200000",
    "number": "1013367036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 S WEST TEMPLE STE 100",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841011443",
            "telephone_number": "801-364-7943",
            "fax_number": "801-364-3373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 S WEST TEMPLE STE 100",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841011443",
            "telephone_number": "801-364-7943",
            "fax_number": "801-364-3373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITY CREEK DENTAL, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-21",
        "last_updated": "2016-06-21",
        "status": "A",
        "authorized_official_last_name": "BYE",
        "authorized_official_first_name": "WALTER",
        "authorized_official_middle_name": "LANDON",
        "authorized_official_title_or_position": "OWNER/PARTNER",
        "authorized_official_telephone_number": "801-364-7943",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "UT",
            "license": "5673900",
            "primary": true
        },
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "UT",
            "license": "7991108",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2016; 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.