Jeremy Ranch Dental Center

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

57294409922 Issued in UT

Legal business name

JEREMY RANCH DENTAL CENTER

Doing business as

Albion Dental Center

Practice address

2700 Homestead Rd
Suite # 130
Park City, UT 84098-4857

Phone

(435) 940-9900

NPI assigned

Aug 27, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Benjamin Russell, D.M.D.NPI 1013331339

Title

Dentist

Phone

(435) 940-9900

Specialties & licenses 1

Addresses

Other names 1

• Albion Dental Center Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Benjamin Russell, D.D.S.

  • Dentist
  • Park City, UT
  • NPI 1013331339
  NPD (past) Authorized official

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

{
    "created_epoch": "1156636800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1144338575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 HOMESTEAD RD",
            "address_2": "SUITE # 130",
            "city": "PARK CITY",
            "state": "UT",
            "postal_code": "840984857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 HOMESTEAD RD",
            "address_2": "SUITE # 130",
            "city": "PARK CITY",
            "state": "UT",
            "postal_code": "840984857",
            "telephone_number": "435-940-9900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEREMY RANCH DENTAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "RUSSELL",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "435-940-9900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "UT",
            "license": "57294409922",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Albion Dental Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Margaret Afton Jahries, APRN
• Mark W Jankowske, D.O.
• Kelsey Rose Janusch, NP-C
• Jasima Reynolds
• Kara Lynne Jensen
• Jessica Dawn Jewell, M.S.
• Sheetal Yogesh Jhaveri, DPT
• Sandra Joder, NP
• Alyssa Hitch Johnson, L.AC
• Catania Johnson, ACMHC, NCC

• General Practice Dentistry in Park City, UT
• Providers in Park City, UT by specialty
• General Practice Dentistry in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.