Individual provider Active NPI

Jacob Roy Rounds, DDS

  • General Practice Dentistry
  • Logan, UT
National Provider Identifier
1164059408
Registry record updated Aug 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
11847736-8903 Issued in UT
Practice address
1260 N 200 E
Logan, UT 84341-7560
Phone
(435) 752-8000
NPI assigned
Mar 26, 2020
Sex
Male
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

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

LicenseStateTypeSpecialty
11847736-8903UTMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Rounds Dental, PLLC CurrentSince May 21, 2023 Accepting new patients

Locations

291 S Main St
Ste A
Smithfield, UT 84335
Phone (435) 563-6213

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 11847736-8903 UT Primary

Addresses

NPPES NPI Registry

Primary practice location

1260 N 200 E
Logan, UT 84341-7560

Mailing address

1260 N 200 E Ste 9
Logan, UT 84341-2382
Phone (435) 752-8000

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 8, 2022.

{
    "created_epoch": "1585180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659916800000",
    "number": "1164059408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1260 N 200 E STE 9",
            "city": "LOGAN",
            "state": "UT",
            "postal_code": "843412382",
            "telephone_number": "435-752-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1260 N 200 E",
            "city": "LOGAN",
            "state": "UT",
            "postal_code": "843417560",
            "telephone_number": "435-752-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROUNDS",
        "first_name": "JACOB",
        "middle_name": "ROY",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-26",
        "last_updated": "2022-08-08",
        "certification_date": "2022-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "UT",
            "license": "11847736-8903",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Logan, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 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.