Active NPI
Paige Holbrook
- Public Health Dentistry
- Taylorsville, UT
National Provider Identifier
1164050860
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Public Health Dentistry
- License
- 1222527
- Practice address
- 4745 S 3200 W
Taylorsville, UT 84129-2822 - Phone
- (801) 964-6214
- NPI assigned
- Mar 29, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Public Health Dentistry | 1223D0001X | 1222527 | UT | Primary |
Addresses
Primary practice location
4745 S 3200 W
Taylorsville, UT 84129-2822
Mailing address
530 S Wakara Way
Salt Lake City, UT 84108-1213
Phone (801) 587-2162
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 |
|---|---|---|---|
| 1222527 | UT | MD | Public Health Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1585440000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1635379200000",
"number": "1164050860",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "530 S WAKARA WAY",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841081213",
"telephone_number": "801-587-2162"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4745 S 3200 W",
"city": "TAYLORSVILLE",
"state": "UT",
"postal_code": "841292822",
"telephone_number": "801-964-6214"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLBROOK",
"first_name": "PAIGE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-03-29",
"last_updated": "2021-10-28",
"certification_date": "2021-10-28",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "1223D0001X",
"taxonomy_group": "",
"desc": "Dentist, Dental Public Health",
"state": "UT",
"license": "1222527",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Taylorsville, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.