Active NPI
Raymond Scott Hlavaty
- Orthodontics and Dentofacial Orthopedics Dentistry
- Logan, UT
National Provider Identifier
1023186111
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- 932604579921
- Legal business name
- RAYMOND SCOTT HLAVATY
- Practice address
- 150 E 200 No
Ste a
Logan, UT 84321 - Phone
- (435) 753-2828
- Fax
- (435) 753-3628
- NPI assigned
- Nov 30, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Raymond Scott Hlavaty, DMD MS
- Title
- President Owner
- Phone
- (435) 753-2828
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 932604579921 | UT | Primary |
Addresses
Primary practice location
150 E 200 No
Ste a
Logan, UT 84321
Mailing address
150 E 200 No
Ste a
Logan, UT 84321
Phone (435) 753-2828
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 528170323003 | Medicaid | UT |
National Provider Directory
National Provider DirectoryLocations
150 E 200 N
Ste A
Logan, UT 84321
Phone (435) 753-2828
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Orthodontics and Dentofacial Orthopedics Dentistry
- Logan, UT
- NPI 1821553785
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164844800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1217376000000",
"number": "1023186111",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "150 E 200 NO",
"address_2": "STE A",
"city": "LOGAN",
"state": "UT",
"postal_code": "84321",
"telephone_number": "435-753-2828",
"fax_number": "435-753-3628"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "150 E 200 NO",
"address_2": "STE A",
"city": "LOGAN",
"state": "UT",
"postal_code": "84321",
"telephone_number": "435-753-2828",
"fax_number": "435-753-3628"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "RAYMOND SCOTT HLAVATY",
"organizational_subpart": "NO",
"enumeration_date": "2006-11-30",
"last_updated": "2008-07-30",
"status": "A",
"authorized_official_last_name": "HLAVATY",
"authorized_official_first_name": "RAYMOND",
"authorized_official_middle_name": "SCOTT",
"authorized_official_title_or_position": "PRESIDENT OWNER",
"authorized_official_telephone_number": "435-753-2828",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "DMD MS"
},
"taxonomies": [
{
"code": "1223X0400X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "UT",
"license": "932604579921",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "528170323003",
"state": "UT"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Logan, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.