Provo Family Dentistry, LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

275985-9922 Issued in UT

Legal business name

PROVO FAMILY DENTISTRY, LLC

Practice address

1355 N University Ave Ste 310
Provo, UT 84604-2721

Phone

(801) 373-2693

NPI assigned

Oct 16, 2017

Organization subpart

No

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

Authorized official

Name

Mrs. Christy Hardman

Title

Office Manager

Phone

(801) 373-2693

Specialties & licenses 1

Addresses

Other names 1

• The Dental Edge Doing business as

Practitioners 1

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

• Steven K. Flick, D.M.D.

  • General Practice Dentistry
  • Provo, UT
  • NPI 1023162252
  NPD (past)

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

{
    "created_epoch": "1508112000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1508112000000",
    "number": "1063923258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1355 N UNIVERSITY AVE STE 310",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846042721",
            "telephone_number": "801-373-2693"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1355 N UNIVERSITY AVE STE 310",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846042721",
            "telephone_number": "801-373-2693"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVO FAMILY DENTISTRY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-16",
        "last_updated": "2017-10-16",
        "status": "A",
        "authorized_official_last_name": "HARDMAN",
        "authorized_official_first_name": "CHRISTY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "801-373-2693",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "UT",
            "license": "275985-9922",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Dental Edge",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Provo Counseling Center
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• Provo Dental Care LLC
• Provo Dialysis Center University of Utah
• Provo Downtown Dental, LLC
• Provo House of Hope
• Provo Orem Family & Cosmetic Dentistry PLLC
• Provo PDC PLLC
• Provo Peak Chiropractic LLC
• Provo Pediatric Dental

• Dental Clinic/Center in Provo, UT
• Providers in Provo, UT by specialty
• Dental Clinic/Center in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 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.