Active NPI
Daniel Jed Snedaker, DDS
- Dentist
- South Jordan, UT
National Provider Identifier
1134564388
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 8689248-9922
- Practice address
- 11535 S Jordan Bend Rd
South Jordan, UT 84095-8066 - Phone
- (801) 360-8868
- NPI assigned
- May 1, 2013
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 8689248-9922 | UT | Primary |
Addresses
Primary practice location
11535 S Jordan Bend Rd
South Jordan, UT 84095-8066
Mailing address
11535 S Jordan Bend Rd
South Jordan, UT 84095-8066
Phone (801) 360-8868
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150813011285 | UT | Order and Referring Only - Dentist | 6103131594 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8689248-9922 | UT | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1367366400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1371600000000",
"number": "1134564388",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11535 S JORDAN BEND RD",
"city": "SOUTH JORDAN",
"state": "UT",
"postal_code": "840958066",
"telephone_number": "801-360-8868"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11535 S JORDAN BEND RD",
"city": "SOUTH JORDAN",
"state": "UT",
"postal_code": "840958066",
"telephone_number": "801-360-8868"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SNEDAKER",
"first_name": "DANIEL",
"middle_name": "JED",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-05-01",
"last_updated": "2013-06-19",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "UT",
"license": "8689248-9922",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in South Jordan, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.