Individual provider Active NPI

Gregory George Pearson, D.M.D.

  • General Practice Dentistry
  • Salt Lake City, UT
National Provider Identifier
1033135504
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
136058 Issued in UT
Practice address
1955 S 1300 E
Suite L-1
Salt Lake City, UT 84105-3638
Phone
(801) 487-5805
Fax
(801) 487-3415
NPI assigned
Jul 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 136058 UT Primary

Addresses

Primary practice location

1955 S 1300 E
Suite L-1
Salt Lake City, UT 84105-3638

Mailing address

1955 S 1300 E
Suite L-1
Salt Lake City, UT 84105-3638
Phone (801) 487-5805

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

LicenseStateTypeSpecialty
136058UTMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
G. George Pearson, DMD & Craig B. Theurer, DDS, P.C. General Practice Past Accepting new patients

Networks

  • UT PPO D-SNP

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1152921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1033135504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1955 S 1300 E",
            "address_2": "SUITE L-1",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841053638",
            "telephone_number": "801-487-5805",
            "fax_number": "801-487-3415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1955 S 1300 E",
            "address_2": "SUITE L-1",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841053638",
            "telephone_number": "801-487-5805",
            "fax_number": "801-487-3415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEARSON",
        "first_name": "GREGORY",
        "middle_name": "GEORGE",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "UT",
            "license": "136058",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

  • 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.