Dane Joseph Nelson, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

7579281-9922 Issued in UT

Practice address

5872 S 900 E Ste 202
Salt Lake City, UT 84121-1682

Phone

(801) 281-8433

Fax

(801) 281-8455

NPI assigned

Jun 14, 2016

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Wasatch Dental Group LLC

  dba Oquirrh Mountain Dental

  • General Practice Dentistry
  • South Jordan, UT
  • NPI 1700409695
  NPD Authorized official
• Nelson & Tillmann Family Dentistry, PC

  dba Nelson & Tillmann Family Dentistry, P.L.L.C.

  • General Practice Dentistry
  • Salt Lake City, UT
  • NPI 1700315462
  NPD

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

{
    "created_epoch": "1465862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465862400000",
    "number": "1114377744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5872 S 900 E STE 202",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841211682",
            "telephone_number": "801-281-8433",
            "fax_number": "801-281-8455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5872 S 900 E STE 202",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841211682",
            "telephone_number": "801-281-8433",
            "fax_number": "801-281-8455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "DANE",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-06-14",
        "last_updated": "2016-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "UT",
            "license": "7579281-9922",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chylie Nelson
• Clint Reid Nelson, M.D.
• Colette R Nelson, LSUDC
• Courtney Nelson
• Curtis Nelson
• Deja Rayne Nelson, DNP, APRN, FNP-C
• Douglas Scott Nelson, MD
• Edward W. Nelson, MD
• Erica Marie Nelson
• Gary Rex Nelson, M.D.

• 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 Jun 14, 2016; 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.