Active NPI
Michael Lee Tribe, D.D.S.
- General Practice Dentistry
- Ogden, UT
National Provider Identifier
1104973395
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 143106-9922
- Practice address
- 1770 E 5625 S Ste 1
Ogden, UT 84403-5067 - Phone
- (801) 475-4700
- Fax
- (801) 475-1888
- NPI assigned
- Jan 3, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 143106-9922 | UT | Primary |
Addresses
Primary practice location
1770 E 5625 S Ste 1
Ogden, UT 84403-5067
Mailing address
1770 E 5625 S Ste 1
Ogden, UT 84403-5067
Phone (801) 475-4700
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160502001434 | UT | Order and Referring Only - Dentist | 5597064295 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167782400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1320710400000",
"number": "1104973395",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1770 E 5625 S STE 1",
"city": "OGDEN",
"state": "UT",
"postal_code": "844035067",
"telephone_number": "801-475-4700",
"fax_number": "801-475-1888"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1770 E 5625 S STE 1",
"city": "OGDEN",
"state": "UT",
"postal_code": "844035067",
"telephone_number": "801-475-4700",
"fax_number": "801-475-1888"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TRIBE",
"first_name": "MICHAEL",
"middle_name": "LEE",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-03",
"last_updated": "2011-11-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "UT",
"license": "143106-9922",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Ogden, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2011; 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.