City Creek Dental, PLLC

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

Organization subpart

No

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

Authorized official

Name

Walter Landon Bye, DDS

Title

Owner/Partner

Phone

(801) 364-7943

Specialties & licenses 2

Addresses

Locations

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": []
}

• Damian Cisneros-Pasillas
• Cora Cisneros
• Natalie Adair Cisney, PA
• Brittney Pauline Ciszek, DDS, PHD
• City Center Psychology, PLLC
• City Creek Medical Specialists, Inc
• City Creek Senior Living LLC
• City Creek Surgical Services
• City of South Salt Lake
• City Therapy LLC

• Dental Clinic/Center in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Dental Clinic/Center in Utah

• 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.