Mitchell G Rudd, DDS

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

5328713-9922 Issued in UT

Practice address

1955 S 1300 E Ste 6
Salt Lake City, UT 84105-3684

Phone

(801) 487-0758

Fax

(801) 487-0750

NPI assigned

Oct 2, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: mrudd297057@direct.med.utah.edu

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.

• Salt Lake Endodontics

  • Endodontics
  • Salt Lake City, UT
  • NPI 1568612133
  NPD (past) Authorized official

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1221782400000",
    "number": "1124111323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1955 S 1300 E STE 6",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841053684",
            "telephone_number": "801-487-0758",
            "fax_number": "801-487-0750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1955 S 1300 E STE 6",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841053684",
            "telephone_number": "801-487-0758",
            "fax_number": "801-487-0750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUDD",
        "first_name": "MITCHELL",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-02",
        "last_updated": "2008-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "UT",
            "license": "5328713-9922",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA NUMBER",
            "identifier": "01595375",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Zachary A. Rubnitz, MD
• Crystal Anne Ruby, APRN
• Emma June Ruchala
• Ashley K Rudd
• Jayce Tyrel Rudd
• Nick J Rudelich, DDS
• Nathan M Ruden, MD
• Angela Rudishauser
• Talia Rudkin
• Ashley Rudman

• Endodontics in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Endodontics in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2008; 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.