NPIMap

Individual provider Active NPI

Casey Wood Clifford, D.D.S.

  • Dentist
  • Salt Lake City, UT
National Provider Identifier
1083958433
Registry record updated Nov 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
8448000-9922 Issued in UT
Practice address
928 E 100 S
Suite E
Salt Lake City, UT 84102-1455
Phone
(801) 355-5657
NPI assigned
Nov 23, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 23, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 8448000-9922 UT Primary

Addresses

Primary practice location

928 E 100 S
Suite E
Salt Lake City, UT 84102-1455

Mailing address

928 E 100 S
Suite E
Salt Lake City, UT 84102-1455
Phone (801) 355-5657

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
8448000-9922UTMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Ismile at SLC Dentist Past Accepting new patients
Jason G Barton DDS Inc Dentist Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1353628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1353628800000",
    "number": "1083958433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "928 E 100 S",
            "address_2": "SUITE E",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841021455",
            "telephone_number": "801-355-5657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "928 E 100 S",
            "address_2": "SUITE E",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841021455",
            "telephone_number": "801-355-5657"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLIFFORD",
        "first_name": "CASEY",
        "middle_name": "WOOD",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-11-23",
        "last_updated": "2012-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "UT",
            "license": "8448000-9922",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2012; 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.