NPIMap

Organization Active NPI

Matthew S. Brinkerhoff, P.C.

  • Dentist
  • Bountiful, UT
National Provider Identifier
1154002467
Registry record updated Jul 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
MATTHEW S. BRINKERHOFF, P.C.
Practice address
1512 Renaissance Towne Dr Ste 102
Bountiful, UT 84010-7513
Phone
(801) 298-7728
Fax
(801) 292-0910
NPI assigned
Jul 28, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2023

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

Authorized official

Name
Dr. Matthew S Brinkerhoff, DMDNPI 1104924828
Title
Dentist Owner
Phone
(801) 298-7728

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

1512 Renaissance Towne Dr Ste 102
Bountiful, UT 84010-7513

Mailing address

1512 Renaissance Towne Dr Ste 102
Bountiful, UT 84010-7513
Phone (801) 298-7728

Other identifiers 1

IdentifierTypeStateIssuer
1982085940MedicaidNM

Other names 1

  • Bountiful Dental Care Doing business as

National Provider Directory

National Provider Directory

Locations

1512 Renaissance Towne Dr
Ste 102
Bountiful, UT 84010
Phone (801) 298-7728

Practitioners & affiliated clinicians

Practitioners 2

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": "1690502400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1690502400000",
    "number": "1154002467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1512 RENAISSANCE TOWNE DR STE 102",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840107513",
            "telephone_number": "801-298-7728",
            "fax_number": "801-292-0910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1512 RENAISSANCE TOWNE DR STE 102",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840107513",
            "telephone_number": "801-298-7728",
            "fax_number": "801-292-0910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MATTHEW S. BRINKERHOFF, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-28",
        "last_updated": "2023-07-28",
        "certification_date": "2023-07-28",
        "status": "A",
        "authorized_official_last_name": "BRINKERHOFF",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "DENTIST OWNER",
        "authorized_official_telephone_number": "801-298-7728",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1982085940",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bountiful Dental Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bountiful, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2023; 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.