Roger J Adams, DMD, MS, MBA

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

140656-9924 Issued in UT

Practice address

5373 Green St
Suite 400
Salt Lake City, UT 84123-4680

Phone

(801) 313-7051

Fax

(801) 290-5126

NPI assigned

Jan 20, 2009

Last updated

Jan 20, 2009By the provider in NPPES

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

Credentials

Master of Business Administration, Master of Science

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Sealants for Smiles

  • Dentist
  • Salt Lake City, UT
  • NPI 1326285891
  Authorized official Same address or phone

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

{
    "created_epoch": "1232409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1232409600000",
    "number": "1134366602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "669 ROCKY KNOLL LN",
            "city": "DRAPER",
            "state": "UT",
            "postal_code": "840207659",
            "telephone_number": "801-450-6040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5373 GREEN ST",
            "address_2": "SUITE 400",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841234680",
            "telephone_number": "801-313-7051",
            "fax_number": "801-290-5126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADAMS",
        "first_name": "ROGER",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DMD, MS, MBA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-01-20",
        "last_updated": "2009-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "UT",
            "license": "140656-9924",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mitchell Adams
• Monica Adams
• Nathan G Adams, DMD, MD
• Patrick L. Adams, M.D.
• Roberta Lyn Adams
• Ryan Ned Adams, PHARMD
• Sam Adams, D.C.
• Samantha Adams
• Sandor Adams
• Shawnee Autumn Adams

• Oral and Maxillofacial Surgery (Dentist) in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Oral and Maxillofacial Surgery (Dentist) in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2009; 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.