Active NPI
Michael Calvin Jeppson, D.D.S.
- Dentist
- Saint George, UT
National Provider Identifier
1104013937
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 5262668-9923
- Practice address
- 1224 S River Rd BLDG D
Saint George, UT 84790-8285 - Phone
- (435) 628-9600
- NPI assigned
- Sep 25, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 5262668-9923 | UT | Primary |
Addresses
Primary practice location
1224 S River Rd BLDG D
Saint George, UT 84790-8285
Mailing address
2445 E 2860 S
Saint George, UT 84790-4707
Phone (801) 518-4998
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
| License | State | Type | Specialty |
|---|---|---|---|
| 5262668-9923 | UT | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Michael C. Jeppson Dental P.C. | Past | 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 and National Provider Directory roles.
-
- General Practice Dentistry
- St George, UT
- NPI 1205014487
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1190678400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1190678400000",
"number": "1104013937",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2445 E 2860 S",
"city": "SAINT GEORGE",
"state": "UT",
"postal_code": "847904707",
"telephone_number": "801-518-4998"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1224 S RIVER RD BLDG D",
"city": "SAINT GEORGE",
"state": "UT",
"postal_code": "847908285",
"telephone_number": "435-628-9600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JEPPSON",
"first_name": "MICHAEL",
"middle_name": "CALVIN",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-09-25",
"last_updated": "2007-09-25",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "UT",
"license": "5262668-9923",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint George, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.