NPIMap

Organization Active NPI

Utah Dental Health Professionals, P.C.

  • General Practice Dentistry
  • Herriman, UT
National Provider Identifier
1053158600
Registry record updated Jul 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
UTAH DENTAL HEALTH PROFESSIONALS, P.C.
Doing business as
Boulder Corridor Dental Care
Practice address
14723 S Marketplace Dr
Ste B
Herriman, UT 84096-3361
Phone
(385) 340-7505
Fax
(385) 340-7487
NPI assigned
Jul 11, 2024
Organization subpart
Yes
Parent organization
HEARTLAND DENTALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 11, 2024

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

Authorized official

Name
Hillary Thull
Title
Credentialing Coordinator
Phone
(217) 540-8946

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

14723 S Marketplace Dr
Ste B
Herriman, UT 84096-3361

Mailing address

14723 S Marketplace Dr
Ste B
Herriman, UT 84096-3361

Other names 1

  • Boulder Corridor Dental Care Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Utah Dental Health Professionals PC4 organizations share this tax ID, including this one
Part of
Utah Dental Health Professionals PC

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

14723 S Marketplace Dr
Ste B
Herriman, UT 84096
Phone (385) 340-7505

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1720656000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1720656000000",
    "number": "1053158600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14723 S MARKETPLACE DR",
            "address_2": "STE B",
            "city": "HERRIMAN",
            "state": "UT",
            "postal_code": "840963361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14723 S MARKETPLACE DR",
            "address_2": "STE B",
            "city": "HERRIMAN",
            "state": "UT",
            "postal_code": "840963361",
            "telephone_number": "385-340-7505",
            "fax_number": "385-340-7487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UTAH DENTAL HEALTH PROFESSIONALS, P.C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HEARTLAND DENTAL",
        "enumeration_date": "2024-07-11",
        "last_updated": "2024-07-11",
        "certification_date": "2024-07-02",
        "status": "A",
        "authorized_official_last_name": "THULL",
        "authorized_official_first_name": "HILLARY",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "217-540-8946"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Boulder Corridor Dental Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Herriman, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2024; 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.