NPIMap

Organization Active NPI

Pinebrook Dental Group

  • Dentist
  • Park City, UT
National Provider Identifier
1114148509
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
380199 Issued in UT
Legal business name
PINEBROOK DENTAL GROUP
Practice address
3080 Pinebrook Rd
Suite 2000
Park City, UT 84098-5422
Phone
(435) 649-6688
Fax
(435) 649-0654
NPI assigned
May 1, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Michael Knight, D.D.S.NPI 1396895702
Title
Owner
Phone
(435) 649-6688

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 380199 UT Primary

Addresses

Primary practice location

3080 Pinebrook Rd
Suite 2000
Park City, UT 84098-5422

Mailing address

3080 Pinebrook Rd
Suite 2000
Park City, UT 84098-5422
Phone (435) 649-6688

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1177977600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1114148509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3080 PINEBROOK RD",
            "address_2": "SUITE 2000",
            "city": "PARK CITY",
            "state": "UT",
            "postal_code": "840985422",
            "telephone_number": "435-649-6688",
            "fax_number": "435-649-0654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3080 PINEBROOK RD",
            "address_2": "SUITE 2000",
            "city": "PARK CITY",
            "state": "UT",
            "postal_code": "840985422",
            "telephone_number": "435-649-6688",
            "fax_number": "435-649-0654"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINEBROOK DENTAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KNIGHT",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "435-649-6688",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "UT",
            "license": "380199",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Park City, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.