Individual provider Active NPI

R Scott Dickson, D.D.S.

  • General Practice Dentistry
  • Salt Lake City, UT
National Provider Identifier
1124158209
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
143233-9922 Issued in UT
Practice address
2040 Murray Holladay Rd
#200
Salt Lake City, UT 84117-5185
Phone
(801) 277-1424
Fax
(801) 277-0724
NPI assigned
Mar 6, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 143233-9922 UT Primary

Addresses

Primary practice location

2040 Murray Holladay Rd
#200
Salt Lake City, UT 84117-5185

Mailing address

2040 Murray Holladay Rd
#200
Salt Lake City, UT 84117-5185
Phone (801) 277-1424

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150720002828 UT Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 1951614932

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Interoperability endpoints

  • Direct secure messaging: sdickson297028@direct.med.utah.edu

NPI Registry JSON

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1124158209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2040 MURRAY HOLLADAY RD",
            "address_2": "#200",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841175185",
            "telephone_number": "801-277-1424",
            "fax_number": "801-277-0724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2040 MURRAY HOLLADAY RD",
            "address_2": "#200",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841175185",
            "telephone_number": "801-277-1424",
            "fax_number": "801-277-0724"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DICKSON",
        "first_name": "R",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "UT",
            "license": "143233-9922",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.