Creek Capital Ivory Ridge LLC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

CREEK CAPITAL IVORY RIDGE LLC

Doing business as

Burg Children's Dentistry & Orthodontics-Ivory Ridge

Practice address

3401 N Center St Ste 250
Lehi, UT 84043-7501

Phone

(801) 407-6520

NPI assigned

Aug 30, 2017

Last updated

Aug 30, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Marci Nicol

Title

Coo

Phone

(801) 312-7122

Specialties & licenses 1

Addresses

Other names 1

• Burg Children's Dentistry & Orthodontics-Ivory Ridge Doing business as

Locations

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

{
    "created_epoch": "1504051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1504051200000",
    "number": "1033637970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "678 E VINE ST STE 10",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841075500",
            "telephone_number": "801-918-4135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 N CENTER ST STE 250",
            "city": "LEHI",
            "state": "UT",
            "postal_code": "840437501",
            "telephone_number": "801-407-6520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CREEK CAPITAL IVORY RIDGE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-30",
        "last_updated": "2017-08-30",
        "status": "A",
        "authorized_official_last_name": "NICOL",
        "authorized_official_first_name": "MARCI",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "801-312-7122"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Burg Children's Dentistry & Orthodontics-Ivory Ridge",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Adam Cox
• Cameron Bradley Cox, LCSW
• Dana Cox
• Kevin James Cox, PT CSCS
• Stephen Brett Cracroft, CRNA
• Rebecca B Crosby
• Crossroads Youth Services
• Crossroads Youth Services Inc
• Alisha Crump
• Daniel Cruttenden, CRNA

• Pediatric Dentistry in Lehi, UT
• Providers in Lehi, UT by specialty
• Pediatric Dentistry in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2017; 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.