Active NPI
Rodney Tyson Gardner I, DMD
- Dentist
- Tremonton, UT
National Provider Identifier
1144710781
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 7832773-9922
- Practice address
- 814 E Main St
Tremonton, UT 84337-6733 - Phone
- (435) 257-3880
- NPI assigned
- May 17, 2018
- Last updated
- May 17, 2018
- Sex
- Male
- Sole proprietor
- No
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 | 7832773-9922 | UT | Primary |
Addresses
Primary practice location
814 E Main St
Tremonton, UT 84337-6733
Mailing address
644 S 900 E
Brigham City, UT 84302-4316
Phone (435) 452-1267
Other practice location 1
1445 N 400 E Ste 3A
Logan, UT 84341-7564
Phone (435) 752-1699
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7832773-9922 | UT | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| 3G Dental LLC | Past | Accepting new patients | |
| North Logan PDC PLLC | Dentist | Past | Accepting new patients |
| 3Gdental LLC | Past | Accepting new patients |
Organizations & group practices 3
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1526515200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1526515200000",
"number": "1144710781",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "644 S 900 E",
"city": "BRIGHAM CITY",
"state": "UT",
"postal_code": "843024316",
"telephone_number": "435-452-1267"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "814 E MAIN ST",
"city": "TREMONTON",
"state": "UT",
"postal_code": "843376733",
"telephone_number": "435-257-3880"
}
],
"practiceLocations": [
{
"address_1": "1445 N 400 E Ste 3A",
"address_purpose": "LOCATION",
"city": "Logan",
"state": "UT",
"postal_code": "843417564",
"country_code": "US",
"telephone_number": "435-752-1699",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GARDNER",
"first_name": "RODNEY",
"middle_name": "TYSON",
"name_suffix": "I",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-05-17",
"last_updated": "2018-05-17",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "UT",
"license": "7832773-9922",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tremonton, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.