The Avenues Family Dentistry

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

7828837 Issued in UT

Legal business name

THE AVENUES FAMILY DENTISTRY

Practice address

215 S 1000 E Ste a
Salt Lake City, UT 84102-2486

Phone

(801) 328-4173

Fax

(801) 322-3995

NPI assigned

Dec 11, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Paul Mark Porter, DDSNPI 1881907475

Title

President

Phone

(435) 760-0189

Specialties & licenses 1

Addresses

Locations

Practitioners 2

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

• Paul M Porter, D.D.S.

  • General Practice Dentistry
  • Salt Lake City, UT
  • NPI 1881907475
  NPD (past) Authorized official
• Jeffory Lynn Broman, DDS

  • Dentist
  • Salt Lake City, UT
  • NPI 1518103340
  NPD (past)

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

{
    "created_epoch": "1292025600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1292025600000",
    "number": "1093018111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 S 1000 E STE A",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841022486",
            "telephone_number": "801-328-4173",
            "fax_number": "801-322-3995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 S 1000 E STE A",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841022486",
            "telephone_number": "801-328-4173",
            "fax_number": "801-322-3995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE AVENUES FAMILY DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-11",
        "last_updated": "2010-12-11",
        "status": "A",
        "authorized_official_last_name": "PORTER",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "MARK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "435-760-0189",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "UT",
            "license": "7828837",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Salt Lake City, UT
• Providers in Salt Lake 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 Dec 11, 2010; 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.