Individual provider Active NPI

Andrew Mark Bateman, DMD

  • General Practice Dentistry
  • Lehi, UT
National Provider Identifier
1174052849
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
7326780-9922 Issued in UT
Practice address
2961 W Maple Loop Dr Ste 110
Lehi, UT 84043-5717
Phone
(801) 766-4042
Fax
(801) 766-6664
NPI assigned
Jun 7, 2017
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 7326780-9922 UT Primary

Addresses

Primary practice location

2961 W Maple Loop Dr Ste 110
Lehi, UT 84043-5717

Mailing address

2961 W Maple Loop Dr Ste 110
Lehi, UT 84043-5717
Phone (801) 766-4042

Other practice location 1

1308 East Eagle Mountain Blvd
Eagle Mountain, UT 84005
Phone (801) 876-7669

Other practice location 2

1513 N Jackson St
Tullahoma, TN 37388-2343
Phone (931) 588-3199

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180117002752 TN Order and Referring Only - DentistPractitioner - Dentist 2567721640

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7326780-9922UTMDGeneral Practice Dentistry
10649TNMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Thanksgiving Point PDC PLLC General Practice CurrentSince Apr 20, 2025 Accepting new patients
Andrew M. Bateman DMD, PLLC CurrentSince Dec 22, 2019 Accepting new patients
Emergency Dentist Salt Lake City LLC General Practice Current Accepting new patients
Pony Express Dental Daybreak, LLC Past Accepting new patients
Ab Dental LLC General Practice PastSince Dec 1, 2019 Accepting new patients
Pony Express Dental LLC Past Accepting new patients

Locations

2961 W Maple Loop Dr
Ste 110
Lehi, UT 84048
Phone (801) 766-4042

Organizations & group practices 6

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": "1496793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1174052849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2961 W MAPLE LOOP DR STE 110",
            "city": "LEHI",
            "state": "UT",
            "postal_code": "840435717",
            "telephone_number": "801-766-4042",
            "fax_number": "801-766-6664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2961 W MAPLE LOOP DR STE 110",
            "city": "LEHI",
            "state": "UT",
            "postal_code": "840435717",
            "telephone_number": "801-766-4042",
            "fax_number": "801-766-6664"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1308 East Eagle Mountain Blvd",
            "address_purpose": "LOCATION",
            "city": "Eagle Mountain",
            "state": "UT",
            "postal_code": "84005",
            "country_code": "US",
            "telephone_number": "801-876-7669",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1513 N Jackson St",
            "address_purpose": "LOCATION",
            "city": "Tullahoma",
            "state": "TN",
            "postal_code": "373882343",
            "country_code": "US",
            "telephone_number": "931-588-3199",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BATEMAN",
        "first_name": "ANDREW",
        "middle_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-07",
        "last_updated": "2022-07-21",
        "certification_date": "2019-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "UT",
            "license": "7326780-9922",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lehi, UT

Sources for this page

Verify at the official NPI Registry.