Eric Michael Visser, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

RES2 Issued in ME

Practice address

1060 E 100 S Ste 205
Salt Lake City, UT 84102-1691

Phone

(801) 355-3286

NPI assigned

Aug 31, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Genesis Dental of Salt Lake, LLC

  • General Practice Dentistry
  • Salt Lake City, UT
  • NPI 1710095781
  NPD (past)

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

{
    "created_epoch": "1283212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1360281600000",
    "number": "1053627844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "668 S BRIXEN CT",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841023910",
            "telephone_number": "801-836-1290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1060 E 100 S STE 205",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841021691",
            "telephone_number": "801-355-3286"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VISSER",
        "first_name": "ERIC",
        "middle_name": "MICHAEL",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-08-31",
        "last_updated": "2013-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "ME",
            "license": "RES2",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "436103099",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Vision Experts Inc. (Knighton Vision)
• Visionworks Inc (Visionworks)
• Visionworks, Inc. (Visionworks)
• David H. Viskochil, MD
• Joseph Viskochil
• Jesse Nichole Visser, RN
• Vista Counseling Services, LLC
• Vistas Care Inc
• Melissa Vitale, MD
• Vitality Medical Inc.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2013; 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.