Active NPI
Justin Cook, DDS
- General Practice Dentistry
- Roy, UT
National Provider Identifier
1023375417
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 10785225
- Practice address
- 3626 W 5600 S Ste D
Roy, UT 84067-9162 - Phone
- (801) 985-2273
- NPI assigned
- Apr 23, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 10785225 | UT | Primary |
Addresses
Primary practice location
3626 W 5600 S Ste D
Roy, UT 84067-9162
Mailing address
1350 E 2600 N
North Ogden, UT 84414-2522
Phone (214) 679-2379
Other practice location 1
4896 S 1900 W Ste B
Roy, UT 84067-2994
Phone (801) 773-9198
Other practice location 2
5856 Harrison Blvd Ste B
South Ogden, UT 84403-2117
Phone (801) 475-7776
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10785225 | UT | MD | General Practice Dentistry |
Practice roles (2 of 3)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Moore Legacy Dental | Past | Accepting new patients | |
| South Ogden Smiles, PC | General Practice | Past | Accepting new patients |
Networks
- UT PPO D-SNP
Organizations & group practices 2
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.
-
- Dental Clinic/Center
- Roy, UT
- NPI 1649952086
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1335139200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1690502400000",
"number": "1023375417",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1350 E 2600 N",
"city": "NORTH OGDEN",
"state": "UT",
"postal_code": "844142522",
"telephone_number": "214-679-2379"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3626 W 5600 S STE D",
"city": "ROY",
"state": "UT",
"postal_code": "840679162",
"telephone_number": "801-985-2273"
}
],
"practiceLocations": [
{
"address_1": "4896 S 1900 W Ste B",
"address_purpose": "LOCATION",
"city": "Roy",
"state": "UT",
"postal_code": "840672994",
"country_code": "US",
"telephone_number": "801-773-9198",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "5856 Harrison Blvd Ste B",
"address_purpose": "LOCATION",
"city": "South Ogden",
"state": "UT",
"postal_code": "844032117",
"country_code": "US",
"telephone_number": "801-475-7776",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "COOK",
"first_name": "JUSTIN",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-04-23",
"last_updated": "2023-07-28",
"certification_date": "2023-07-28",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "UT",
"license": "10785225",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Roy, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.