Organization Active NPI

Raymond Scott Hlavaty

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Logan, UT
National Provider Identifier
1023186111
Registry record updated Jul 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
932604579921 Issued in UT
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

Updated by the provider on Jul 30, 2008

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

Authorized official

Name
Dr. Raymond Scott Hlavaty, DMD MSNPI 1821553785
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)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 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

IdentifierTypeStateIssuer
528170323003MedicaidUT

National Provider Directory

National Provider Directory

Locations

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.

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.

Verify at the official NPI Registry.