Big Kahuna Dental, LLC Dba Aloha Dental

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

7579613-9923 Issued in UT

Legal business name

BIG KAHUNA DENTAL, LLC DBA ALOHA DENTAL

Practice address

2792 S 5600 W
West Valley City, UT 84120-5590

Phone

(801) 969-9669

Fax

(801) 969-9779

NPI assigned

Jun 25, 2014

Last updated

Mar 23, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kase Peery

Title

Business Manager

Phone

(801) 969-9669

Specialties & licenses 6

Addresses

Locations

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

{
    "created_epoch": "1403654400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1458691200000",
    "number": "1073928305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2792 S 5600 W",
            "city": "WEST VALLEY CITY",
            "state": "UT",
            "postal_code": "841205590",
            "telephone_number": "801-969-9669",
            "fax_number": "801-969-9779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2792 S 5600 W",
            "city": "WEST VALLEY CITY",
            "state": "UT",
            "postal_code": "841205590",
            "telephone_number": "801-969-9669",
            "fax_number": "801-969-9779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BIG KAHUNA DENTAL, LLC DBA ALOHA DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-25",
        "last_updated": "2016-03-23",
        "status": "A",
        "authorized_official_last_name": "PEERY",
        "authorized_official_first_name": "KASE",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "801-969-9669"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "UT",
            "license": "5672733-9922",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "UT",
            "license": "8919236-9921",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "UT",
            "license": "7579613-9923",
            "primary": true
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "UT",
            "license": "9474332-9922",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "UT",
            "license": "135181-9924",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "UT",
            "license": "317724-8903",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Josef A Benzon, D.M.D.
• Wayne Berg, FNP
• Heather Missy Berkel, APRN
• Lanette Rose Best, CMHC
• Aga Bienkowski
• Christie Ann Bigham, CPM LDEM
• Chloe Juliet Bikman
• Gabrielle D Bissell, AUD
• Annalisa Blackham
• Jamie Blackwell

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2016; 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.