Individual provider Active NPI

David W Pincock I, DMD

  • General Practice Dentistry
  • Orem, UT
National Provider Identifier
1043427453
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
4936843-9922 Issued in UT
Practice address
1694 N State St
Orem, UT 84057-2542
Phone
(801) 762-0100
Fax
(801) 762-0101
NPI assigned
May 16, 2007
Sex
Male
Sole proprietor
Yes

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 4936843-9922 UT Primary

Addresses

Primary practice location

1694 N State St
Orem, UT 84057-2542

Mailing address

1694 N State St
Orem, UT 84057-2542
Phone (801) 762-0100

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
4936843-9922UTMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1179273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1043427453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1694 N STATE ST",
            "city": "OREM",
            "state": "UT",
            "postal_code": "840572542",
            "telephone_number": "801-762-0100",
            "fax_number": "801-762-0101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1694 N STATE ST",
            "city": "OREM",
            "state": "UT",
            "postal_code": "840572542",
            "telephone_number": "801-762-0100",
            "fax_number": "801-762-0101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PINCOCK",
        "first_name": "DAVID",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "name_suffix": "I",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "UT",
            "license": "4936843-9922",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orem, 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.