NPIMap

Organization Active NPI

Legacy Trail Family Dental

  • General Practice Dentistry
  • Layton, UT
National Provider Identifier
1154049872
Registry record updated Aug 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
LEGACY TRAIL FAMILY DENTAL
Practice address
1014 W Gentile St Ste a
Layton, UT 84041-4646
Phone
(801) 698-4555
NPI assigned
Aug 18, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2022

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

Authorized official

Name
Brent Milne, DMDNPI 1740479328
Title
Owner
Phone
(801) 698-4555

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
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

1014 W Gentile St Ste a
Layton, UT 84041-4646

Mailing address

1014 W Gentile St Ste a
Layton, UT 84041-4646
Phone (801) 698-4555

National Provider Directory

National Provider Directory

Locations

1014 W Gentile St
Ste A
Layton, UT 84041
Phone (801) 698-4555

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": "1660780800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660780800000",
    "number": "1154049872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1014 W GENTILE ST STE A",
            "city": "LAYTON",
            "state": "UT",
            "postal_code": "840414646",
            "telephone_number": "801-698-4555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1014 W GENTILE ST STE A",
            "city": "LAYTON",
            "state": "UT",
            "postal_code": "840414646",
            "telephone_number": "801-698-4555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEGACY TRAIL FAMILY DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-18",
        "last_updated": "2022-08-18",
        "certification_date": "2022-08-18",
        "status": "A",
        "authorized_official_last_name": "MILNE",
        "authorized_official_first_name": "BRENT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "801-698-4555",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Layton, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2022; 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.