Bart Wilson Wolthuis, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

140299 Issued in UT

Practice address

512 12TH Street
Ogden, UT 84404

Phone

(801) 399-5831

NPI assigned

Feb 12, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in UT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles (1 of 2)

Networks

• UT PPO D-SNP

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Canyon Dental Group LLC

  • General Practice Dentistry
  • Ogden, UT
  • NPI 1669887204
  NPD (past) Authorized official

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

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1023150679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "512 12TH STREET",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "84404",
            "telephone_number": "801-399-5831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "512 12TH STREET",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "84404",
            "telephone_number": "801-399-5831"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLTHUIS",
        "first_name": "BART",
        "middle_name": "WILSON",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "UT",
            "license": "140299",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Abby Winward
• Kellie Wittig
• Krissy Wolf
• Matthew R. Wolpert, DMD
• Rachel Ilene Wolsey, LMT
• Braden Wilson Wolthuis, ACNP
• Jared Garner Wolthuis, DDS
• John S Wolthuis, MD
• Jody B Wong, PT
• April Marie Wood

• Dentist in Ogden, UT
• Providers in Ogden, UT by specialty
• Dentist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.