Organization Active NPI

Simply Smiles Dental Utah

  • Dental Clinic/Center
  • West Valley City, UT
National Provider Identifier
1124664834
Registry record updated Jan 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
SIMPLY SMILES DENTAL UTAH
Practice address
2592 S 5600 W Ste 102
West Valley City, UT 84120-1274
Phone
(801) 613-2904
NPI assigned
Nov 18, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2020

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

Authorized official

Name
Alisynn Dickson
Title
Owner
Phone
(801) 613-2904

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

2592 S 5600 W Ste 102
West Valley City, UT 84120-1274

Mailing address

2592 S 5600 W Ste 102
West Valley City, UT 84120-1274
Phone (801) 613-2904

National Provider Directory

National Provider Directory

Locations

2592 S 5600 W
Ste 102
West Valley City, UT 84120
Phone (801) 603-2904

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1574035200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1580342400000",
    "number": "1124664834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2592 S 5600 W STE 102",
            "city": "WEST VALLEY CITY",
            "state": "UT",
            "postal_code": "841201274",
            "telephone_number": "801-613-2904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2592 S 5600 W STE 102",
            "city": "WEST VALLEY CITY",
            "state": "UT",
            "postal_code": "841201274",
            "telephone_number": "801-613-2904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIMPLY SMILES DENTAL UTAH",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-18",
        "last_updated": "2020-01-30",
        "certification_date": "2020-01-30",
        "status": "A",
        "authorized_official_last_name": "DICKSON",
        "authorized_official_first_name": "ALISYNN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "801-613-2904"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Valley City, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 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.