Gregory W Egbert DDS MSD PC

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

143512 Issued in UT

Legal business name

GREGORY W EGBERT DDS MSD PC

Practice address

1250 E 3900 So
Ste 210
SLC, UT 84124-1367

Phone

(801) 265-1500

Fax

(801) 265-1523

NPI assigned

Jul 6, 2006

Organization subpart

No

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

Authorized official

Name

Gregory William Egbert, DDS MSD

Title

Owner

Phone

(801) 265-1500

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1023040763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1250 E 3900 SO",
            "address_2": "STE 210",
            "city": "SLC",
            "state": "UT",
            "postal_code": "841241367",
            "telephone_number": "801-265-1500",
            "fax_number": "801-265-1523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 E 3900 SO",
            "address_2": "STE 210",
            "city": "SLC",
            "state": "UT",
            "postal_code": "841241367",
            "telephone_number": "801-265-1500",
            "fax_number": "801-265-1523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREGORY W EGBERT DDS MSD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "EGBERT",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "801-265-1500",
        "authorized_official_credential": "DDS MSD"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "UT",
            "license": "143512",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "528706087022",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Keely Gove
• Barbara M Grams, PT
• Mary Jo Grant, APRN
• Robert C Gray
• Lauren Greco, BA
• Kathryn Gregson
• Jenna Griego
• Rachel Griffin, MD
• Jacqueline De Anne Griffith
• Hunter Karll Groesbeck

• Oral and Maxillofacial Surgery (Dentist) in SLC, UT
• Providers in SLC, UT by specialty
• Oral and Maxillofacial Surgery (Dentist) in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.