Greater Endodontics LLC

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

5639652 Issued in UT

Legal business name

GREATER ENDODONTICS LLC

Practice address

5334 South Woodrow Street
Suite 201
Salt Lake City, UT 84107

Phone

(801) 268-3636

Fax

(801) 942-7652

NPI assigned

Dec 4, 2017

Organization subpart

No

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

Authorized official

Name

Randall Madsen, DDS

Title

Managing Member

Phone

(801) 268-3636

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1512345600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1512345600000",
    "number": "1043725799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 71277",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "84171",
            "telephone_number": "801-268-3636",
            "fax_number": "801-942-7652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5334 SOUTH WOODROW STREET",
            "address_2": "SUITE 201",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "84107",
            "telephone_number": "801-268-3636",
            "fax_number": "801-942-7652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREATER ENDODONTICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-04",
        "last_updated": "2017-12-04",
        "status": "A",
        "authorized_official_last_name": "MADSEN",
        "authorized_official_first_name": "RANDALL",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "801-268-3636",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Endodontics",
            "state": "UT",
            "license": "5639652",
            "primary": true
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Endodontics",
            "state": "UT",
            "license": "77525365",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shannon L Graziani
• Kelli Marie Graziano
• Scott Graziosa, D.C., B.S.
• Diana Grazulis, MD
• Great Basin Chiropractic P.C.
• Frank E Greaves Sr., LSA
• Jesse N Greaves, D.M.D.
• Talon Greeff, L.P.C.
• Green Chiropractic Center, Inc
• Green Chiropractic Clinic PC

• Endodontics in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Endodontics in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 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.