Wasatch Advanced Dental Care LLC

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

Legal business name

WASATCH ADVANCED DENTAL CARE LLC

Practice address

3590 Harrison Blvd Suite #1
Ogden, UT 84403

Phone

(801) 621-4800

Fax

(801) 340-9561

NPI assigned

Jul 5, 2019

Organization subpart

No

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

Authorized official

Name

Mr. Aaron T. Ward, DMD MS PC

Title

Dentist

Phone

(801) 621-4800

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1562284800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1562284800000",
    "number": "1023670569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3590 HARRISON BLVD SUITE #1",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "84403",
            "telephone_number": "801-621-4800",
            "fax_number": "801-340-9561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3590 HARRISON BLVD SUITE #1",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "84403",
            "telephone_number": "801-621-4800",
            "fax_number": "801-340-9561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WASATCH ADVANCED DENTAL CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-05",
        "last_updated": "2019-07-05",
        "status": "A",
        "authorized_official_last_name": "WARD",
        "authorized_official_first_name": "AARON",
        "authorized_official_middle_name": "T.",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "801-621-4800",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DMD MS PC"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Periodontics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Naomi Warner
• Shayley Marie Warner, CMHC
• Cyrus Mace Warren, LCSW
• Jonathan Randall Warren, PHARMD
• Teresa Lee Warwood, APRN
• Wasatch Dental Association, P.C.
• Wasatch Dermatology, PC
• Wasatch Physical and Rehabilitation Medicine, P.C.
• Wasatch Podiatry PLLC
• Wasatch Post-Acute Services

• All providers in Ogden, UT
• Periodontics in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2019; 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.