Individual provider Active NPI

John Shea Bess, DDS

  • Dentist
  • South Jordan, UT
National Provider Identifier
1073622817
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
5110182 Issued in UT
Practice address
3556 West 9800 South
Ste 102
South Jordan, UT 84095
Phone
(801) 280-5558
Fax
(801) 446-9818
NPI assigned
Aug 29, 2006
Last updated
Jul 8, 2007By the provider in NPPES
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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 5110182 UT Primary

Addresses

Primary practice location

3556 West 9800 South
Ste 102
South Jordan, UT 84095

Mailing address

3556 West 9800 South
Ste 102
South Jordan, UT 84095
Phone (801) 280-5558

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160107002633 UT Order and Referring Only - DentistPractitioner - Dentist 5193027191

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5110182UTMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Jaybird Audiology, LLC PastSince Mar 13, 2019 Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1073622817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3556 WEST 9800 SOUTH",
            "address_2": "STE 102",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "84095",
            "telephone_number": "801-280-5558",
            "fax_number": "801-446-9818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3556 WEST 9800 SOUTH",
            "address_2": "STE 102",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "84095",
            "telephone_number": "801-280-5558",
            "fax_number": "801-446-9818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BESS",
        "first_name": "JOHN",
        "middle_name": "SHEA",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "UT",
            "license": "5110182",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Jordan, UT

Sources for this page

Verify at the official NPI Registry.