Mark Brooks Murdock, D.D.S

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

4931937-9922 Issued in UT

Practice address

30 E 700 S
Brigham City, UT 84302-3235

Phone

(435) 734-2248

Fax

(435) 723-0778

NPI assigned

Jun 20, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Eagle Mountain Dental, LLC

  • Dentist
  • Brigham City, UT
  • NPI 1649793407
  NPD (past) Authorized official

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

{
    "created_epoch": "1150761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1104862275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "698 W 700 S",
            "city": "BRIGHAM CITY",
            "state": "UT",
            "postal_code": "843022875",
            "telephone_number": "435-723-0629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 E 700 S",
            "city": "BRIGHAM CITY",
            "state": "UT",
            "postal_code": "843023235",
            "telephone_number": "435-734-2248",
            "fax_number": "435-723-0778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MURDOCK",
        "first_name": "MARK",
        "middle_name": "BROOKS",
        "name_prefix": "Mr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "UT",
            "license": "4931937-9922",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "UT",
            "license": "4931937-8903",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brett Moyes
• Nicholas Moyle
• Amberly Munns
• Haylee Munns
• Kiera Munns
• Lance Eric Murie
• Michelle Murphey
• Doyle Murphy
• Jacob Murphy
• Kenady Nacey

• General Practice Dentistry in Brigham City, UT
• Providers in Brigham 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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.