Jorge Samuel Quiroz, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

11055196 Issued in UT

Practice address

3725 W 4100 S Ste 240
West Valley City, UT 84120-5434

Phone

(801) 965-2700

NPI assigned

Mar 26, 2019

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

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 Granger

  • General Practice Dentistry
  • West Valley City, UT
  • NPI 1548685266
  NPD (past)
• Genesis Orthodontics, LLC

  • Dental Clinic/Center
  • West Valley City, UT
  • NPI 1609372903
  NPD (past)

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

{
    "created_epoch": "1553558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565740800000",
    "number": "1053872705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6087 S REDWOOD RD STE C",
            "city": "TAYLORSVILLE",
            "state": "UT",
            "postal_code": "841236854",
            "telephone_number": "801-352-1300",
            "fax_number": "801-285-9170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3725 W 4100 S STE 240",
            "city": "WEST VALLEY CITY",
            "state": "UT",
            "postal_code": "841205434",
            "telephone_number": "801-965-2700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUIROZ",
        "first_name": "JORGE",
        "middle_name": "SAMUEL",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-26",
        "last_updated": "2019-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "UT",
            "license": "11055196",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samantha Pulido
• Danielle Renee Puri, ARNP
• Cathey A Putnam, MD
• Quality Books & Audio LTD (Health Education Materials)
• Quest Diagnostics Clinical Laboratories Inc
• Martin I Radwin, MD
• Faiza Rafi, PHD
• Winter Ralphs
• Shae Ramirez
• Trent Rasmussen, MD

• General Practice Dentistry in West Valley City, UT
• Providers in West Valley City, UT by specialty
• General Practice Dentistry in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2019; 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.