Individual provider Active NPI

Joseph Feller, DMD, MS

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Bountiful, UT
National Provider Identifier
1053471896
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
5852983 Issued in UT
Practice address
625 E 500 S
Suite 201
Bountiful, UT 84010-3882
Phone
(801) 295-3467
Fax
(801) 295-5786
NPI assigned
Dec 11, 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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 8972 CO
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 5852983 UT Primary

Addresses

Primary practice location

625 E 500 S
Suite 201
Bountiful, UT 84010-3882

Mailing address

625 E 500 S
Suite 201
Bountiful, UT 84010-3882
Phone (801) 295-3467

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
8972COMDOrthodontics and Dentofacial Orthopedic Dentist
5852983UTMDOrthodontics and Dentofacial Orthopedic Dentist

NPI Registry JSON

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1053471896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 E 500 S",
            "address_2": "SUITE 201",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840103882",
            "telephone_number": "801-295-3467",
            "fax_number": "801-295-5786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 E 500 S",
            "address_2": "SUITE 201",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840103882",
            "telephone_number": "801-295-3467",
            "fax_number": "801-295-5786"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FELLER",
        "first_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "DMD, MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CO",
            "license": "8972",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "UT",
            "license": "5852983",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bountiful, 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.